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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 11/2020

01-10-2020 | Metastasis | Hepatobiliary Tumors

Time to Recurrence After Surgical Resection and Survival After Recurrence Among Patients with Perihilar and Distal Cholangiocarcinomas

Authors: Yoshitsugu Nakanishi, MD, PhD, Keisuke Okamura, MD, PhD, Takahiro Tsuchikawa, MD, PhD, Toru Nakamura, MD, PhD, Takehiro Noji, MD, PhD, Toshimichi Asano, MD, PhD, Aya Matsui, MD, PhD, Kimitaka Tanaka, MD, PhD, Soichi Murakami, MD, PhD, Yuma Ebihara, MD, PhD, Yo Kurashima, MD, PhD, Hajime Narasaki, MD, PhD, Toraji Amano, MD, PhD, Toshiaki Shichinohe, MD, PhD, Satoshi Hirano, MD, PhD

Published in: Annals of Surgical Oncology | Issue 11/2020

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Abstract

Background

The differences between perihilar cholangiocarcinoma (PHCC) and distal cholangiocarcinoma (DCC) regarding recurrence and the factors that affect recurrence after surgery are unclear. This study aims to investigate the differences in recurrence patterns between patients with PHCC and those with DCC after surgical resection with curative intent. It also investigates the risk factors associated with recurrence and survival thereafter.

Patients and Methods

The postoperative courses of 366 patients with extrahepatic cholangiocarcinomas (EHCCs), including 236 with PHCC and 130 with DCC, who underwent surgical resections were investigated retrospectively.

Results

During follow-up, tumors recurred in 143 (60.6%) patients with PHCC and in 72 (55.4%) patients with DCC. Overall survival (OS) after surgery, recurrence-free survival (RFS), and OS after recurrence were similar for the patients with PHCC and those with DCC. The cumulative probability of recurrence declined 3 years after surgery in the patients with PHCC and those with DCC. A multivariable analysis determined that, among the patients with PHCC and those with DCC, regional lymph node metastasis was a significant risk factor associated with RFS. Ten patients with PHCC and eight patients with DCC with two or fewer sites of recurrence in a single organ underwent resections. A multivariable analysis determined that recurrent tumor resection was an independent prognostic factor associated with OS after recurrence in the patients with PHCC and those with DCC.

Conclusions

Postoperative survival did not differ between the patients with PHCC and those with DCC. Frequent surveillances for recurrence are needed for 3 years after surgical resection of EHCCs. In selected patients, surgery for recurrent EHCCs might be associated with improved outcomes.
Appendix
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Metadata
Title
Time to Recurrence After Surgical Resection and Survival After Recurrence Among Patients with Perihilar and Distal Cholangiocarcinomas
Authors
Yoshitsugu Nakanishi, MD, PhD
Keisuke Okamura, MD, PhD
Takahiro Tsuchikawa, MD, PhD
Toru Nakamura, MD, PhD
Takehiro Noji, MD, PhD
Toshimichi Asano, MD, PhD
Aya Matsui, MD, PhD
Kimitaka Tanaka, MD, PhD
Soichi Murakami, MD, PhD
Yuma Ebihara, MD, PhD
Yo Kurashima, MD, PhD
Hajime Narasaki, MD, PhD
Toraji Amano, MD, PhD
Toshiaki Shichinohe, MD, PhD
Satoshi Hirano, MD, PhD
Publication date
01-10-2020
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 11/2020
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-020-08534-2

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