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01-01-2021 | Cholangiocarcinoma | Original Scientific Report

Impact of Remnant Carcinoma in Situ at the Ductal Stump on Long-Term Outcomes in Patients with Distal Cholangiocarcinoma

Authors: Koya Yasukawa, Akira Shimizu, Hiroaki Motoyama, Koji Kubota, Tsuyoshi Notake, Kentaro Fukushima, Tomohiko Ikehara, Hikaru Hayashi, Akira Kobayashi, Yuji Soejima

Published in: World Journal of Surgery | Issue 1/2021

Abstract

Background

The management of positive ductal margins with carcinoma in situ (R1-CIS) after resection is controversial. The aim of this study was to evaluate the impact of R1-CIS on survival in patients who underwent resection for distal cholangiocarcinoma.

Methods

We enrolled 121 consecutive patients with distal cholangiocarcinoma. Poor prognostic factors were investigated by multivariable analysis, and we performed a stratified analysis to evaluate the impact of R1-CIS on survival in patients with or without prognostic factors.

Results

Multivariable analysis identified node-positive status as the prognostic factor (P = 0.003). Stratified by lymph node status, overall survival (OS) in the R0 group was significantly better than that in the R1-CIS group in node-negative patients (57.1% vs 30.0%; P < 0.050). Although OS was comparable between the two groups in node-positive patients (5-year OS: 22.2% vs 20.0%, respectively; P = not significant). Furthermore, OS in patients in whom R0 was achieved by additional resection was significantly better than that in patients with R1-CIS (5-year OS: 66.7% vs 30.0%, respectively; P < 0.050).

Conclusions

Remnant CIS is associated with a poor prognosis in patients with node-negative distal cholangiocarcinoma. Every effort should be made to achieve negative bile duct margins.

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Title: Impact of Remnant Carcinoma in Situ at the Ductal Stump on Long-Term Outcomes in Patients with Distal Cholangiocarcinoma
Authors: Koya Yasukawa
Akira Shimizu
Hiroaki Motoyama
Koji Kubota
Tsuyoshi Notake
Kentaro Fukushima
Tomohiko Ikehara
Hikaru Hayashi
Akira Kobayashi
Yuji Soejima
Publication date: 01-01-2021
Publisher: Springer International Publishing
Keywords: Cholangiocarcinoma
Cholangiocarcinoma
Published in: World Journal of Surgery / Issue 1/2021
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-020-05799-2

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Springer Medicine

Impact of Remnant Carcinoma in Situ at the Ductal Stump on Long-Term Outcomes in Patients with Distal Cholangiocarcinoma

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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