Patterns of First Failure after Management of Hilar Cholangiocarcinoma.
- Author:
Tae Jun BANG
1
;
Keon Young LEE
;
Min Young YOON
;
Yoon Mi CHOI
;
Sun Keun CHOI
;
Yoon Seok HUR
;
Sei Joong KIM
;
Young Up JO
;
Seung Ik AHN
;
Kee Chun HONG
;
Kyung Rae KIM
;
Seok Hwan SHIN
;
Ze Hong WOO
Author Information
1. Departments of Surgery, Inha University College of Medicine, Incheon, Korea. 196087@inha.ac.kr
- Publication Type:Original Article
- Keywords:
Hilar Cholangiocarcinoma;
Recurrence;
Resection margin
- MeSH:
Chemotherapy, Adjuvant;
Cholangiocarcinoma*;
Disease Progression;
Disease-Free Survival;
Humans;
Medical Records;
Proportional Hazards Models;
Radiotherapy;
Recurrence;
Retrospective Studies
- From:Korean Journal of Hepato-Biliary-Pancreatic Surgery
2007;11(3):40-47
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: This study was conducted to evaluate the patterns of disease progression following either resection or palliative management of hilar cholangiocarcinoma and to clarify the polarity of the resection margin. METHODS: The medical records of 78 hilar cholangiocarcinoma patients who were admitted to the Inha University Hospital between June of 1996 and May of 2006 were retrospectively reviewed. The patterns of recurrence were compared between the margin positive, margin negative and palliative management groups, and factors influencing recurrence and survival were then analyzed using the Cox proportional hazard model. RESULTS: The hilar cholangiocarcinoma recurred or progressed in 56 patients (71.8%) following the initial treatment, and the median progression free survival (PFS) time was 10.1 months. The 3-yr estimates of overall relapse and the median PFS were 90.7% and 17 months, respectively, in the resection group (n=32) and 100% and 7 months, respectively, in the palliative group (n=46) (p=0.045). There was no significant difference observed in the 3-yr estimates of overall disease progression or the median PFS according to the margin positivity or resection methods. When the disease progression pattern was analyzed, there was no significant difference observed between the groups, however, the survival analysis showed that survival was greater in the group that underwent resection with curative intent than in the palliative management group (p=0.001). Adjuvant chemotherapy or radiotherapy had no effect on recurrence or survival, and poor differentiation was the only significant prognostic factor for survival identified when the Cox proportional hazard model was used. CONCLUSION: Because no difference in the pattern of disease progression existed, aggressive surgical resection should be attempted to prevent recurrence and to increase survival, even in cases in which a suspicious positive resection margin is present.
