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HIGUCHI Ryota
Department School of Medicine(Yachiyo Medical Center), School of Medicine Position Assistant Professor |
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| Article types | Original article |
| Language | English |
| Peer review | Peer reviewed |
| Title | Surgical Outcomes for Perihilar Cholangiocarcinoma with Vascular Invasion. |
| Journal | Formal name：Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract Abbreviation：J Gastrointest Surg ISSN code：18734626/1091255X |
| Volume, Issue, Page | 23(7),pp.1443-1453 |
| Author and coauthor | Higuchi Ryota, Yazawa Takehisa, Uemura Shuichiro, Izumo Wataru, Ota Takehiro, Kiyohara Kosuke, Furukawa Toru, Egawa Hiroto, Yamamoto Masakazu |
| Authorship | Lead author |
| Publication date | 2019/07 |
| Summary | PURPOSE:To investigate short- and long-term surgical outcomes for patients with perihilar cholangiocarcinoma and vascular invasion.METHODS:Data from 249 patients who underwent perihilar cholangiocarcinoma surgery between 2000 and 2016 were retrospectively analyzed. Patient evaluations included short-term surgical outcomes following vascular resection and long-term outcomes in cases with histopathological vascular invasion.RESULTS:Mortality was 3.6% overall; 16% for hepatic artery resections, 5.4% for portal vein resections, and 1.7% in the absence of vascular resection (p = 0.029). No between-group differences were observed in the incidence of Clavien-Dindo grade ≥ 3 complications. The factors related to perioperative mortality were hepatic artery resection (odds ratio [OR] = 25.5), right trisectionectomy (OR = 13.0), and central bisectionectomy (OR = 13.8). Multivariate analysis for overall survival identified several prognostic factors: carcinoembryonic antigen level ≥ 5 ng/mL (hazard ratio [HR] = 1.68), poor differentiation (HR = 2.39), distant metastasis (HR = 1.97), and R1 invasive resection (HR = 2.13). Five-year overall survival for patients with portal vein invasion and M0R0/1cis was 35.6%, significantly worse than the 53.4% for patients with no portal vein invasion and M0R/1cis but better than the 0% for patients with portal vein invasion and M1 or R1. Those with hepatic arterial invasion and M0R0/1cis were 24.7%, significantly worse than the 53.4% for patients with no hepatic arterial invasion and M0R0/1cis but significantly better than the 0% for patients with hepatic arterial invasion and M1 or R1.CONCLUSION:Short-term outcomes for patients with perihilar cholangiocarcinoma and undergoing vascular resection were poor compared to those without vascular resection. Long-term survival in R0M0 disease was more favorable; aggressive surgery is recommended. |
| DOI | 10.1007/s11605-018-3948-x |
| PMID | 30203230 |