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Confinement to the intrapancreatic bile duct if independently associated with a better prognosis in extrahepatic cholangiocarcinoma

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Affiliated Author(s)
안근수강구정김용훈김태석강유나
Alternative Author(s)
Ahn, Keun SooKang, Koo JeongKim, Yong HoonKim, Tae SeokKang, Yu Na
Journal Title
BMC Gastroenterology
ISSN
1471-230X
Issued Date
2016
Keyword
Extrahepatic cholangiocarcinomaLocationPrognosis
Abstract
Background: Actual differences of long term outcome of extrahepatic cholangiocarcinoma according to the
location of the tumor have not yet been studied. The aim of this study was to evaluate the prognosis and optimal
surgical procedure for middle (BD) cancer.
Methods: Among 109 patients with carcinoma of the extrahepatic BD underwent surgical resection, curative
resection of extrahepatic BD cancer was performed in 90 patients. They were classified into three groups according
to the location of tumors: DISTAL (n = 32), tumor was confined to the intrapancreatic bile duct; MID (n = 20), tumor
was located between below the confluence of the hepatic duct bifurcation and suprapancreatic portion of the BD;
and DIFFUSE (n = 38), tumor was located diffusely.
Results: Tumor involving the middle BD (MID or DIFFUSE) had a higher rate of perineural invasion as compared to
the DISTAL group. The overall and disease-free survival rate for the MID or DIFFUSE group was significantly worse
than that of DISTAL. In the MID/DIFFUSE group, there was no significant difference of survival according to the type
of the operation (pancreaticoduodenectomy or segmental BD resection). The multivariate analysis showed that
tumor involving middle BD (MID or DIFFUSE group) and node metastasis were independently poor prognostic
factors for the disease free and overall survival.
Conclusion: Extrahepatic cholangiocarcinoma involving the extrapancreatic BD has a worse prognosis than
those confined to the intrapancreatic BD. In patients with tumors confined to the middle BD, BD resection
can be considered as an alternative surgical procedure to pancreaticoduodenectomy, if an R0 resection can
be accomplished.
Department
Dept. of Surgery (외과학)
Dept. of Pathology (병리학)
Publisher
School of Medicine
Citation
Keun Soo Ahn et al. (2016). Confinement to the intrapancreatic bile duct if independently associated with a better prognosis in extrahepatic cholangiocarcinoma. BMC Gastroenterology, 16(21), 1–9. doi: 10.1186/s12876-016-0444-1
Type
Article
ISSN
1471-230X
DOI
10.1186/s12876-016-0444-1
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/33172
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Pathology (병리학)
1. School of Medicine (의과대학) > Dept. of Surgery (외과학)
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