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Differences in Prognostic Factors and Recurrence Patterns After Curative-Intent Resection of Perihilar and Distal Cholangiocarcinomas

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Zeitschriftentitel: Scandinavian Journal of Surgery
Personen und Körperschaften: Sallinen, V., Sirén, J., Mäkisalo, H., Lehtimäki, T. E., Lantto, E., Kokkola, A., Nordin, A.
In: Scandinavian Journal of Surgery, 109, 2020, 3, S. 219-227
Medientyp: E-Article
Sprache: Englisch
veröffentlicht:
SAGE Publications
Schlagwörter:
author_facet Sallinen, V.
Sirén, J.
Mäkisalo, H.
Lehtimäki, T. E.
Lantto, E.
Kokkola, A.
Nordin, A.
Sallinen, V.
Sirén, J.
Mäkisalo, H.
Lehtimäki, T. E.
Lantto, E.
Kokkola, A.
Nordin, A.
author Sallinen, V.
Sirén, J.
Mäkisalo, H.
Lehtimäki, T. E.
Lantto, E.
Kokkola, A.
Nordin, A.
spellingShingle Sallinen, V.
Sirén, J.
Mäkisalo, H.
Lehtimäki, T. E.
Lantto, E.
Kokkola, A.
Nordin, A.
Scandinavian Journal of Surgery
Differences in Prognostic Factors and Recurrence Patterns After Curative-Intent Resection of Perihilar and Distal Cholangiocarcinomas
Surgery
author_sort sallinen, v.
spelling Sallinen, V. Sirén, J. Mäkisalo, H. Lehtimäki, T. E. Lantto, E. Kokkola, A. Nordin, A. 1457-4969 1799-7267 SAGE Publications Surgery http://dx.doi.org/10.1177/1457496919832150 <jats:sec><jats:title>Background:</jats:title><jats:p> Perihilar cholangiocarcinoma and distal cholangiocarcinoma arise from the same tissue but require different surgical treatment methods. It remains unclear whether these cholangiocarcinoma types have different outcomes, prognostic factors, and/or recurrence patterns. </jats:p></jats:sec><jats:sec><jats:title>Methods:</jats:title><jats:p> This retrospective study evaluated patients who underwent curative-intent resection for perihilar cholangiocarcinoma or distal cholangiocarcinoma at a tertiary academic hospital during 2000–2015. Survival and prognostic factors were identified using Kaplan–Meier and Cox regression analyses. </jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p> The 90-day mortality rates were 0% for perihilar cholangiocarcinoma (36 patients) and 4% for distal cholangiocarcinoma (47 patients). There were no significant differences between perihilar cholangiocarcinoma or distal cholangiocarcinoma in median overall survival (30.9 vs 40.4 months) or median disease-free survival (14.2 vs 21.4 months). Among perihilar cholangiocarcinoma patients, age &gt; 65 years was an independent predictor of poorer overall survival (hazard ratio: 2.45, 95% confidence interval: 1.07–5.64), while requiring bile duct re-resection was an independent predictor of disease-free survival (hazard ratio: 2.76, 95% confidence interval: 1.01–7.51). Among distal cholangiocarcinoma patients, a pN1 category independently predicted poorer overall survival (hazard ratio: 3.40, 95% confidence interval: 1.14–10.11), while preoperative CA19-9 levels &gt;30 U/mL (hazard ratio: 2.51, 95% confidence interval: 1.09–5.79) and pN1 category (hazard ratio: 2.51, 95% confidence interval: 1.09–5.79) predicted a shorter disease-free survival. Local recurrence was more common with perihilar cholangiocarcinoma (50% of recurrences), while multiple synchronous sites were more common for distal cholangiocarcinoma (41% of recurrences). </jats:p></jats:sec><jats:sec><jats:title>Conclusion:</jats:title><jats:p> Perihilar cholangiocarcinoma and distal cholangiocarcinoma patients have similar survival outcomes. However, local control appears to be more prognostic for perihilar cholangiocarcinoma patients, while positive lymph nodes are critical prognostic factor for distal cholangiocarcinoma patients. </jats:p></jats:sec> Differences in Prognostic Factors and Recurrence Patterns After Curative-Intent Resection of Perihilar and Distal Cholangiocarcinomas Scandinavian Journal of Surgery
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title Differences in Prognostic Factors and Recurrence Patterns After Curative-Intent Resection of Perihilar and Distal Cholangiocarcinomas
title_unstemmed Differences in Prognostic Factors and Recurrence Patterns After Curative-Intent Resection of Perihilar and Distal Cholangiocarcinomas
title_full Differences in Prognostic Factors and Recurrence Patterns After Curative-Intent Resection of Perihilar and Distal Cholangiocarcinomas
title_fullStr Differences in Prognostic Factors and Recurrence Patterns After Curative-Intent Resection of Perihilar and Distal Cholangiocarcinomas
title_full_unstemmed Differences in Prognostic Factors and Recurrence Patterns After Curative-Intent Resection of Perihilar and Distal Cholangiocarcinomas
title_short Differences in Prognostic Factors and Recurrence Patterns After Curative-Intent Resection of Perihilar and Distal Cholangiocarcinomas
title_sort differences in prognostic factors and recurrence patterns after curative-intent resection of perihilar and distal cholangiocarcinomas
topic Surgery
url http://dx.doi.org/10.1177/1457496919832150
publishDate 2020
physical 219-227
description <jats:sec><jats:title>Background:</jats:title><jats:p> Perihilar cholangiocarcinoma and distal cholangiocarcinoma arise from the same tissue but require different surgical treatment methods. It remains unclear whether these cholangiocarcinoma types have different outcomes, prognostic factors, and/or recurrence patterns. </jats:p></jats:sec><jats:sec><jats:title>Methods:</jats:title><jats:p> This retrospective study evaluated patients who underwent curative-intent resection for perihilar cholangiocarcinoma or distal cholangiocarcinoma at a tertiary academic hospital during 2000–2015. Survival and prognostic factors were identified using Kaplan–Meier and Cox regression analyses. </jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p> The 90-day mortality rates were 0% for perihilar cholangiocarcinoma (36 patients) and 4% for distal cholangiocarcinoma (47 patients). There were no significant differences between perihilar cholangiocarcinoma or distal cholangiocarcinoma in median overall survival (30.9 vs 40.4 months) or median disease-free survival (14.2 vs 21.4 months). Among perihilar cholangiocarcinoma patients, age &gt; 65 years was an independent predictor of poorer overall survival (hazard ratio: 2.45, 95% confidence interval: 1.07–5.64), while requiring bile duct re-resection was an independent predictor of disease-free survival (hazard ratio: 2.76, 95% confidence interval: 1.01–7.51). Among distal cholangiocarcinoma patients, a pN1 category independently predicted poorer overall survival (hazard ratio: 3.40, 95% confidence interval: 1.14–10.11), while preoperative CA19-9 levels &gt;30 U/mL (hazard ratio: 2.51, 95% confidence interval: 1.09–5.79) and pN1 category (hazard ratio: 2.51, 95% confidence interval: 1.09–5.79) predicted a shorter disease-free survival. Local recurrence was more common with perihilar cholangiocarcinoma (50% of recurrences), while multiple synchronous sites were more common for distal cholangiocarcinoma (41% of recurrences). </jats:p></jats:sec><jats:sec><jats:title>Conclusion:</jats:title><jats:p> Perihilar cholangiocarcinoma and distal cholangiocarcinoma patients have similar survival outcomes. However, local control appears to be more prognostic for perihilar cholangiocarcinoma patients, while positive lymph nodes are critical prognostic factor for distal cholangiocarcinoma patients. </jats:p></jats:sec>
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author Sallinen, V., Sirén, J., Mäkisalo, H., Lehtimäki, T. E., Lantto, E., Kokkola, A., Nordin, A.
author_facet Sallinen, V., Sirén, J., Mäkisalo, H., Lehtimäki, T. E., Lantto, E., Kokkola, A., Nordin, A., Sallinen, V., Sirén, J., Mäkisalo, H., Lehtimäki, T. E., Lantto, E., Kokkola, A., Nordin, A.
author_sort sallinen, v.
container_issue 3
container_start_page 219
container_title Scandinavian Journal of Surgery
container_volume 109
description <jats:sec><jats:title>Background:</jats:title><jats:p> Perihilar cholangiocarcinoma and distal cholangiocarcinoma arise from the same tissue but require different surgical treatment methods. It remains unclear whether these cholangiocarcinoma types have different outcomes, prognostic factors, and/or recurrence patterns. </jats:p></jats:sec><jats:sec><jats:title>Methods:</jats:title><jats:p> This retrospective study evaluated patients who underwent curative-intent resection for perihilar cholangiocarcinoma or distal cholangiocarcinoma at a tertiary academic hospital during 2000–2015. Survival and prognostic factors were identified using Kaplan–Meier and Cox regression analyses. </jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p> The 90-day mortality rates were 0% for perihilar cholangiocarcinoma (36 patients) and 4% for distal cholangiocarcinoma (47 patients). There were no significant differences between perihilar cholangiocarcinoma or distal cholangiocarcinoma in median overall survival (30.9 vs 40.4 months) or median disease-free survival (14.2 vs 21.4 months). Among perihilar cholangiocarcinoma patients, age &gt; 65 years was an independent predictor of poorer overall survival (hazard ratio: 2.45, 95% confidence interval: 1.07–5.64), while requiring bile duct re-resection was an independent predictor of disease-free survival (hazard ratio: 2.76, 95% confidence interval: 1.01–7.51). Among distal cholangiocarcinoma patients, a pN1 category independently predicted poorer overall survival (hazard ratio: 3.40, 95% confidence interval: 1.14–10.11), while preoperative CA19-9 levels &gt;30 U/mL (hazard ratio: 2.51, 95% confidence interval: 1.09–5.79) and pN1 category (hazard ratio: 2.51, 95% confidence interval: 1.09–5.79) predicted a shorter disease-free survival. Local recurrence was more common with perihilar cholangiocarcinoma (50% of recurrences), while multiple synchronous sites were more common for distal cholangiocarcinoma (41% of recurrences). </jats:p></jats:sec><jats:sec><jats:title>Conclusion:</jats:title><jats:p> Perihilar cholangiocarcinoma and distal cholangiocarcinoma patients have similar survival outcomes. However, local control appears to be more prognostic for perihilar cholangiocarcinoma patients, while positive lymph nodes are critical prognostic factor for distal cholangiocarcinoma patients. </jats:p></jats:sec>
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spelling Sallinen, V. Sirén, J. Mäkisalo, H. Lehtimäki, T. E. Lantto, E. Kokkola, A. Nordin, A. 1457-4969 1799-7267 SAGE Publications Surgery http://dx.doi.org/10.1177/1457496919832150 <jats:sec><jats:title>Background:</jats:title><jats:p> Perihilar cholangiocarcinoma and distal cholangiocarcinoma arise from the same tissue but require different surgical treatment methods. It remains unclear whether these cholangiocarcinoma types have different outcomes, prognostic factors, and/or recurrence patterns. </jats:p></jats:sec><jats:sec><jats:title>Methods:</jats:title><jats:p> This retrospective study evaluated patients who underwent curative-intent resection for perihilar cholangiocarcinoma or distal cholangiocarcinoma at a tertiary academic hospital during 2000–2015. Survival and prognostic factors were identified using Kaplan–Meier and Cox regression analyses. </jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p> The 90-day mortality rates were 0% for perihilar cholangiocarcinoma (36 patients) and 4% for distal cholangiocarcinoma (47 patients). There were no significant differences between perihilar cholangiocarcinoma or distal cholangiocarcinoma in median overall survival (30.9 vs 40.4 months) or median disease-free survival (14.2 vs 21.4 months). Among perihilar cholangiocarcinoma patients, age &gt; 65 years was an independent predictor of poorer overall survival (hazard ratio: 2.45, 95% confidence interval: 1.07–5.64), while requiring bile duct re-resection was an independent predictor of disease-free survival (hazard ratio: 2.76, 95% confidence interval: 1.01–7.51). Among distal cholangiocarcinoma patients, a pN1 category independently predicted poorer overall survival (hazard ratio: 3.40, 95% confidence interval: 1.14–10.11), while preoperative CA19-9 levels &gt;30 U/mL (hazard ratio: 2.51, 95% confidence interval: 1.09–5.79) and pN1 category (hazard ratio: 2.51, 95% confidence interval: 1.09–5.79) predicted a shorter disease-free survival. Local recurrence was more common with perihilar cholangiocarcinoma (50% of recurrences), while multiple synchronous sites were more common for distal cholangiocarcinoma (41% of recurrences). </jats:p></jats:sec><jats:sec><jats:title>Conclusion:</jats:title><jats:p> Perihilar cholangiocarcinoma and distal cholangiocarcinoma patients have similar survival outcomes. However, local control appears to be more prognostic for perihilar cholangiocarcinoma patients, while positive lymph nodes are critical prognostic factor for distal cholangiocarcinoma patients. </jats:p></jats:sec> Differences in Prognostic Factors and Recurrence Patterns After Curative-Intent Resection of Perihilar and Distal Cholangiocarcinomas Scandinavian Journal of Surgery
spellingShingle Sallinen, V., Sirén, J., Mäkisalo, H., Lehtimäki, T. E., Lantto, E., Kokkola, A., Nordin, A., Scandinavian Journal of Surgery, Differences in Prognostic Factors and Recurrence Patterns After Curative-Intent Resection of Perihilar and Distal Cholangiocarcinomas, Surgery
title Differences in Prognostic Factors and Recurrence Patterns After Curative-Intent Resection of Perihilar and Distal Cholangiocarcinomas
title_full Differences in Prognostic Factors and Recurrence Patterns After Curative-Intent Resection of Perihilar and Distal Cholangiocarcinomas
title_fullStr Differences in Prognostic Factors and Recurrence Patterns After Curative-Intent Resection of Perihilar and Distal Cholangiocarcinomas
title_full_unstemmed Differences in Prognostic Factors and Recurrence Patterns After Curative-Intent Resection of Perihilar and Distal Cholangiocarcinomas
title_short Differences in Prognostic Factors and Recurrence Patterns After Curative-Intent Resection of Perihilar and Distal Cholangiocarcinomas
title_sort differences in prognostic factors and recurrence patterns after curative-intent resection of perihilar and distal cholangiocarcinomas
title_unstemmed Differences in Prognostic Factors and Recurrence Patterns After Curative-Intent Resection of Perihilar and Distal Cholangiocarcinomas
topic Surgery
url http://dx.doi.org/10.1177/1457496919832150