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01-08-2013 | Original Article

Perineural Invasion in Extrahepatic Cholangiocarcinoma: Prognostic Impact and Treatment Strategies

Authors: Yoshiaki Murakami, Kenichiro Uemura, Takeshi Sudo, Yasushi Hashimoto, Naru Kondo, Naoya Nakagawa, Takeshi Muto, Hayato Sasaki, Kazuhide Urabe, Taijiro Sueda

Published in: Journal of Gastrointestinal Surgery | Issue 8/2013

Abstract

Background

The significance of perineural invasion in extrahepatic cholangiocarcinoma has not been fully elucidated. This study aims to determine the prognostic impact of and optimal treatment strategy for perineural invasion in patients with extrahepatic cholangiocarcinoma.

Methods

Medical records of 133 patients with extrahepatic cholangiocarcinoma who underwent curative resection were reviewed retrospectively. Ninety-eight patients had perineural invasion and 35 patients did not. Univariate and multivariate survival analyses were performed to clarify the prognostic impact of and optimal treatment strategy for perineural invasion.

Results

Only tumor differentiation (P = 0.024) was independently associated with perineural invasion in the multivariate logistic regression model. Multivariate survival analysis revealed that perineural invasion (P = 0.002), resection margin status (P = 0.016), and International Union Against Cancer (UICC) pT factor (P = 0.015) were independent prognostic factors of overall survival. Overall 5-year survival rates for patients with and without perineural invasion were 28 and 74 %, respectively. Among 98 patients with perineural invasion, the use of adjuvant chemotherapy (P = 0.003), lymph node status (P = 0.015), resection margin status (P = 0.008), and UICC pT factor (P = 0.016) were independently associated with overall survival by multivariate analysis. Overall 5-year survival rates for patients with perineural invasion who did and did not receive adjuvant chemotherapy were 33 and 21 %, respectively (P = 0.023).

Conclusions

Perineural invasion is a potent prognostic factor in extrahepatic cholangiocarcinoma. Adjuvant chemotherapy may improve the overall survival of patients with perineural invasion.

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Title: Perineural Invasion in Extrahepatic Cholangiocarcinoma: Prognostic Impact and Treatment Strategies
Authors: Yoshiaki Murakami
Kenichiro Uemura
Takeshi Sudo
Yasushi Hashimoto
Naru Kondo
Naoya Nakagawa
Takeshi Muto
Hayato Sasaki
Kazuhide Urabe
Taijiro Sueda
Publication date: 01-08-2013
Publisher: Springer US
Published in: Journal of Gastrointestinal Surgery / Issue 8/2013
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-013-2251-0

At a glance: The STEP trials

Springer Medicine

Perineural Invasion in Extrahepatic Cholangiocarcinoma: Prognostic Impact and Treatment Strategies

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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