ヒグチ　リヨウタ   HIGUCHI Riyouta   樋口　亮太    所属   医学部 医学科（附属八千代医療センター）    職種   講師
論文種別	原著
言語種別	英語
査読の有無	査読なし
表題	A Multicenter Retrospective Study on Adjuvant S-1 Chemotherapy Versus Observation Following Major Hepatectomy for Perihilar Cholangiocarcinoma
掲載誌名	正式名：Annals of surgical oncology 略　 称：Ann Surg Oncol ISSNコード：15344681/10689265
掲載区分	国外
巻・号・頁	32(3),pp.1784-1794
著者・共著者	HOSOKAWA Isamu, HIGUCHI Ryota, HOMMA Yuki, TAKASAKI Tsukasa, OME Yusuke, MATSUYAMA Ryusei, TAKANO Shigetsugu, UEMURA Shuichiro, YABUSHITA Yasuhiro, HONDA Goro, ENDO Itaru, OHTSUKA Masayuki
発行年月	2025/03
概要	BACKGROUND:The prognosis of perihilar cholangiocarcinoma (PHC) is poor even after curative resection, highlighting the need for effective adjuvant chemotherapy. The efficacy of adjuvant S-1 chemotherapy following major hepatectomy for PHC is unclear, and thus the aim of this study was to elucidate this.METHODS:Consecutive patients with PHC who underwent major hepatectomy (hemihepatectomy or trisectionectomy extending to segment 1 with extrahepatic bile duct resection) at three high-volume centers in Japan from 2007 to 2020 were retrospectively evaluated. Patients with Clavien-Dindo grade V complications, pStage 0, I, or IVB disease, and those who underwent adjuvant radiation therapy were excluded from analysis. Propensity score matching analysis was performed to compare the disease-specific survival (DSS) of patients who underwent adjuvant S-1 chemotherapy with those who underwent observation.RESULTS:Overall, 373/480 patients were eligible, of whom 81 underwent adjuvant S-1 chemotherapy and 146 underwent observation. In the global cohort, DSS was similar in the S-1 and observation groups (p = 0.18), while in the matched cohort (S-1, n = 44; observation, n = 44), DSS was similar between the S-1 and observation groups (p = 0.09). On multivariate analysis, percutaneous biliary drainage (PTBD), CA19-9 levels of ≥ 300 U/mL at operation, and lymph node (LN) metastasis were independent predictors of poor survival following major hepatectomy for PHC. In subgroup analysis of patients with LN metastasis, DSS was better in the S-1 group than in the observation group (p = 0.001).CONCLUSIONS:Adjuvant S-1 chemotherapy following major hepatectomy might be effective in PHC patients with LN metastasis.
DOI	10.1245/s10434-024-16546-5
PMID	39623190