Abstract
BackgroundVarious chemotherapies have been used as best practice to treat recurrent biliary malignancies. Conversely, relatively few surgeries have been described for recurrent extrahepatic biliary carcinoma (RExBC), so whether surgery for RExBC is feasible has remained unclear. This retrospective study was conducted to evaluate the feasibility of surgery for RExBC.MethodsFrom February 2000 to January 2014, a total of 27 patients, comprising 18 patients with extrahepatic cholangiocarcinoma and 9 patients with gallbladder carcinoma, met our criteria for radical resection of RExBC (resection group). Sites of recurrence consisted of liver metastases (ten patients), local/percutaneous transhepatic cholangio drainage (PTCD) fistula recurrence (eight patients), bile duct recurrence (six patients), and lymph node recurrence (one patient). To evaluate the survival impact of resection, we compared 123 RExBC patients (resection group) with patients who received palliative care (palliative group).ResultsMorbidity and mortality rates in the resection group were 6.6% and 0%, respectively. Overall cumulative 5-year survival rates were 23.5% in the resection group and 0% in the palliative group. Median survival time was 21.6 months in the resection group and 9.5 months in the palliative group, showing a significant difference (p < 0.01). No significant differences in cumulative survival were seen between extrahepatic cholangiocarcinoma and gallbladder carcinoma in the resection group. In addition, no significant differences were seen between liver metastases, bile duct recurrence, and local/percutaneous transhepatic biliary drainage (PTBD) fistula recurrence in the resection group.ConclusionsSurgery appears feasible for RExBC and offers longer survival for selected patients.
Highlights
Various chemotherapies have been used as best practice to treat recurrent biliary malignancies
To evaluate the survival impact of resection for recurrent extrahepatic biliary carcinoma (RExBC), we reviewed the remaining 123 unresectable patients (92 men, 31 women; median age 71 years; range 48 to 84 years) with RExBC
Significant differences in disease-free interval (DFI) were seen between the two groups (p < 0.01, Table 1)
Summary
Various chemotherapies have been used as best practice to treat recurrent biliary malignancies. Relatively few surgeries have been described for recurrent extrahepatic biliary carcinoma (RExBC), so whether surgery for RExBC is feasible has remained unclear. This retrospective study was conducted to evaluate the feasibility of surgery for RExBC. Various chemotherapies have been used as best practice [9]. Few surgeries for recurrent extrahepatic biliary carcinoma (RExBC) have been reported, because secondary (or more) resection for RExBC is known as an extremely demanding procedure.
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