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Kojima, Toru Department of Surgery, Okayama Saiseikai General Hospital
Umeda, Yuzo Department of Gastroenterological Surgery, Okayama University Kaken ID researchmap
Fuji, Tomokazu Department of Surgery, Okayama Saiseikai General Hospital
Niguma, Takefumi Department of Surgery, Okayama Saiseikai General Hospital
Satoh, Daisuke Department of surgery, Hiroshima City Hiroshima Citizens Hospital
Endo, Yoshikatsu Department of Surgery, Himeji Japanese Red Cross Hospital
Sui, Kenta Department of Gastroenterological Surgery at Kochi Health Sciences Center
Inagaki, Masaru Department of Surgery, National Hospital Organization Fukuyama Medical Center
Oishi, Masahiro Department of Surgery, Tottori Municipal Hospital
Ota, Tetsuya Department of Surgery, National Hospital Organization Okayama Medical Center
Hioki, Katsuyoshi Department of Surgery, Fukuyama City Hospital
Matsuda, Tadakazu Department of Surgery, Tenwakai Matsuda Hospital
Aoki, Hideki Department of Surgery, National Hospital Organization Iwakuni Medical Center
Hirai, Ryuji Department of Surgery, Himeji Saint Mary’s Hospital
Kimura, Masashi Department of Surgery, Matsuyama City Hospital
Yagi, Takahito Department of Gastroenterological Surgery, Okayama University Kaken ID publons researchmap
Fujiwara, Toshiyoshi Department of Gastroenterological Surgery, Okayama University ORCID Kaken ID publons researchmap
Abstract
Background The prognosis of intrahepatic cholangiocarcinoma (ICC) has been poor, because of the high recurrence rate even after curative surgery. This study aimed to evaluate the prognostic impact of surgical resection of recurrent ICC. Patients and methods A total of 345 cases of ICC who underwent hepatectomy with curative intent in 17 institutions were retrospectively analyzed, focusing on recurrence patterns and treatment modalities for recurrent ICC. Results Median survival time and overall 5-year recurrence-free survival rate were 17.8 months and 28.5%, respectively. Recurrences (n = 223) were classified as early (recurrence at <= 1 year, n = 131) or late (recurrence at >1 year, n = 92). Median survival time was poorer for early recurrence (16.3 months) than for late recurrence (47.7 months,p<0.0001). Treatment modalities for recurrence comprised surgical resection (n = 28), non-surgical treatment (n = 134), and best supportive care (BSC) (n = 61). Median and overall 1-/5-year survival rates after recurrence were 39.5 months and 84.6%/36.3% for surgical resection, 14.3 months and 62.5%/2.9% for non-surgical treatment, and 3 months and 4.8%/0% for BSC, respectively (p<0.0001). Multivariate analysis identified early recurrence, simultaneous intra- and extrahepatic recurrence, and surgical resection of recurrence as significant prognostic factors. In subgroup analyses, surgical resection may have positive prognostic impacts on intra- and extrahepatic recurrences, and even on early recurrence. However, simultaneous intra- and extrahepatic recurrence may not see any survival benefit from surgical management. Conclusion Surgical resection of recurrent ICC could improve survival after recurrence, especially for patients with intra- or extrahepatic recurrence as resectable oligo-metastases.
Published Date
2020-09-03
Publication Title
PLOS ONE
Volume
volume15
Issue
issue9
Publisher
PUBLIC LIBRARY SCIENCE
Start Page
e0238392
ISSN
1932-6203
Content Type
Journal Article
language
英語
OAI-PMH Set
岡山大学
Copyright Holders
© 2020 Kojima et al.
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publisher
PubMed ID
DOI
Web of Science KeyUT
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isVersionOf https://doi.org/10.1371/journal.pone.0238392
License
https://creativecommons.org/licenses/by/4.0/
Funder Name
Japan Society for the Promotion of Science
助成番号
19K09217