Bile Duct/Gall BladderRecurrence after curative-intent resection of perihilar cholangiocarcinoma: analysis of a large cohort with a close postoperative follow-up approach
Section snippets
Patients
Between January 2001 and December 2012, consecutive patients who underwent curative-intent resection of PCC in the First Department of Surgery, Nagoya University Hospital were reviewed retrospectively, with special attention to recurrence patterns. Curative-intent resection was defined as macroscopically complete resection of the tumor. This study was approved by the Human Research Review Committee of Nagoya University Hospital.
Preoperative management
Blood tests including tumor markers (carcinoembryonic antigen and
Results
During the study period, 484 consecutive patients with PCC underwent resection. Of these, 82 were excluded, including 64 patients with pM1 disease, 7 with a R2 resection, 10 (2.1%) who died of postoperative complications, and 1 without detailed follow-up information. The remaining 402 patients, including 251 men and 151 women with a median age of 67 years (range, 34–85 years), were enrolled in the present study.
Of the 402 study patients, 396 (98.5%) underwent hepatectomy with en bloc resection
Discussion
Several studies16, 17, 18, 19, 20, 21, 22 have investigated recurrence after resection of PCC, but they had a number of limitations. First, they all had a small sample size16, 20, 21, 22 and/or included a heterogeneous group of patients, such as those with or without positive surgical margins.17, 18, 19, 20, 21, 22 We considered that the surgical margin status (R status) could affect the patterns of recurrence and RFS; therefore, the present study analyzed the data according to R status.
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