Metastasectomy for Recurrent or Metastatic Biliary Tract Cancers: A Single Center Experience.
- Author:
Joonhwan KIM
1
;
Youngwoo JANG
;
Jungwoo SHIM
;
Jongwook YU
;
Dong Bok SHIN
;
Inkeun PARK
Author Information
1. Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.
- Publication Type:Original Article
- Keywords:
Biliary tract neoplasms;
Neoplasm metastasis;
Metastasectomy;
Prognosis
- MeSH:
Ampulla of Vater;
Biliary Tract Neoplasms*;
Biliary Tract*;
Cholangiocarcinoma;
Common Bile Duct;
Diagnosis;
Female;
Follow-Up Studies;
Gallbladder Neoplasms;
Humans;
Liver;
Lymph Nodes;
Metastasectomy*;
Neoplasm Metastasis;
Peritoneum;
Prognosis;
Retrospective Studies;
Tertiary Care Centers
- From:Soonchunhyang Medical Science
2016;22(1):1-7
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: Efficacy or long-term result of metastasectomy for recurrent or metastatic biliary tract carcinoma (BTC) is not well established. We conducted a retrospective review of the outcomes of metastasectomy for recurrent or metastatic BTCs. METHODS: The clinicopathological features and outcomes of consecutive patients with BTCs who underwent surgical resection for primary and metastatic disease at a tertiary referral hospital from 2003 to 2013 were reviewed retrospectively. RESULTS: We found 19 eligible patients. Median age of patients was 57 years old (range, 27 to 68 years old), and 11 patients (58%) were female. Primary sites were gallbladder cancer (seven patients, 37%), intrahepatic cholangiocarcinoma (five patients, 26%), distal common bile duct cancer (three patients, 16%), proximal common bile duct cancer (two patients, 11%), and ampulla of Vater cancer (two patients, 11%). Eight patients (42%) had synchronous metastasis, while 11 (58%) had metachronous metastasis. The most common metastatic site was liver (nine patients, 47%), lymph node (nine patients, 47%), and peritoneum (three patients, 16%). Nine patients (47%) achieved R0 resection, while four (21%) and six (32%) patients had R1 and R2 resection, respectively. With a median follow-up period of 26.7 months, the estimated median overall survival (OS) was 18.2 months (95% confidence interval [CI], 13.6 to 22.9 months). Lower Eastern Cooperative Oncology Group performance status (P=0.023), metachronous metastasis (P=0.04), absence of lymph node metastasis (P=0.009), lower numbers of metastatic organs (P<0.001), normal postoperative carbohydrate antigen 19-9 level (P=0.034), and time from diagnosis to metastasectomy more than one year (P=0.019) were identified as prognostic factors for a longer OS after metastasectomy. CONCLUSION: For recurrent or metastatic BTCs, metastasectomy can be a viable option for selected patients.
