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Impact of Remnant Carcinoma in Situ at the Ductal Stump on Long-Term Outcomes in Patients with Distal Cholangiocarcinoma.

Abstract：

BACKGROUND:The management of positive ductal margins with carcinoma in situ (R1-CIS) after resection is controversial. The aim of this study was to evaluate the impact of R1-CIS on survival in patients who underwent resection for distal cholangiocarcinoma. METHODS:We enrolled 121 consecutive patients with distal cholangiocarcinoma. Poor prognostic factors were investigated by multivariable analysis, and we performed a stratified analysis to evaluate the impact of R1-CIS on survival in patients with or without prognostic factors. RESULTS:Multivariable analysis identified node-positive status as the prognostic factor (P = 0.003). Stratified by lymph node status, overall survival (OS) in the R0 group was significantly better than that in the R1-CIS group in node-negative patients (57.1% vs 30.0%; P < 0.050). Although OS was comparable between the two groups in node-positive patients (5-year OS: 22.2% vs 20.0%, respectively; P = not significant). Furthermore, OS in patients in whom R0 was achieved by additional resection was significantly better than that in patients with R1-CIS (5-year OS: 66.7% vs 30.0%, respectively; P < 0.050). CONCLUSIONS:Remnant CIS is associated with a poor prognosis in patients with node-negative distal cholangiocarcinoma. Every effort should be made to achieve negative bile duct margins.

journal_name

World J Surg

journal_title

World journal of surgery

authors

Yasukawa K,Shimizu A,Motoyama H,Kubota K,Notake T,Fukushima K,Ikehara T,Hayashi H,Kobayashi A,Soejima Y

doi

10.1007/s00268-020-05799-2

subject

Has Abstract

pub_date

2021-01-01 00:00:00

pages

291-301

issue

1

eissn

0364-2313

issn

1432-2323

pii

10.1007/s00268-020-05799-2

journal_volume

45

pub_type

杂志文章

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