教員業績データベース |
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論文種別 | 原著 |
言語種別 | 英語 |
査読の有無 | 査読なし |
表題 | Significant Improvement in Outcomes of Patients with Intrahepatic Cholangiocarcinoma after Surgery |
掲載誌名 | 正式名:World journal of surgery 略 称:World J Surg ISSNコード:1432-2323(Electronic)0364-2313(Linking) |
掲載区分 | 国外 |
巻・号・頁 | 40(9),pp.2229-36 |
著者・共著者 | Yoh Tomoaki, Hatano Etsuro, Nishio Takahiro, Seo Satoru, Taura Kojiro, Yasuchika Kentaro, Okajima Hideaki, Kaido Toshimi, Uemoto Shinji |
発行年月 | 2016/09 |
概要 | BACKGROUND:The prognosis of intrahepatic cholangiocarcinoma (ICC) remains poor despite improvements in treatment and post-operative clinical management. We review our experiences and evaluate our current surgical approaches by comparing patients from two consecutive treatment periods.METHODS:One hundred forty-four patients who underwent hepatectomy for ICC between 1993 and 2014 were divided into groups that received treatment before (n = 65, first period) and after 2006 (n = 79, second period), when new treatment options such as adjuvant chemotherapy and multimodal therapy for recurrence were introduced. Clinicopathological characteristics and survival outcomes were compared between the groups.RESULTS:First-period patients exhibited more advanced tumor characteristics, including larger tumors, higher serum carbohydrate antigen 19-9 levels, and vascular invasion. Median overall survival (OS) durations of the first- and second-period groups were 21.4 and 57.7 months, respectively (p RESULTS:<RESULTS: 0.001); corresponding median disease-free survival (DFS) durations were 12.2 and 16.6 months, respectively (p = 0.027). Multivariate analysis found an independent association of the treatment time period with OS and DFS. Notably, second-period patients with N1 disease achieved a longer OS and DFS (median OS time: 12.4 and 26.0 months, p = 0.0018, and median DFS: 4.7 and 10.7 months p = 0.019, respectively). Among recurrent patients (first, n = 50 and second, n = 44), second-period patients had a significantly longer survival after recurrence (8.0 vs. 22.3 months, p RESULTS:<RESULTS: 0.001).CONCLUSION:ICC patients, particularly those with N1 disease, achieved significant survival improvements that were partly attributable to patient selection, adjuvant chemotherapy, and multimodal treatment after recurrence. |
DOI | 10.1007/s00268-016-3583-1 |
PMID | 27255940 |