J Korean Surg Soc.  2011 Sep;81(3):187-194. 10.4174/jkss.2011.81.3.187.

Survival benefits of surgical resection in recurrent cholangiocarcinoma

• Song SC
• Heo JS
• Choi DW
• Choi SH
• Kim WS
• Kim MJ

• KMID: 2212196
• DOI: http://doi.org/10.4174/jkss.2011.81.3.187

Abstract

PURPOSE
Attempt to identify the beneficial effects associated with surgical procedures on survival outcome of patients with recurrent cholangiocarcinoma.
METHODS
921 patients diagnosed with cholangiocarcinoma underwent surgical resection with curative intent in a single institute during the last 15 years. Patients with recurrent disease were divided into two groups according to whether surgical procedures were performed for the treatment of recurrence. Clinicopathologic variables, ranges of survival based on sites of recurrence, and types of treatment were analyzed retrospectively.
RESULTS
The median follow-up period was 21.8 months and 316 (34.3%) patients had recurrence. 27 (group A) patients with recurrent disease were treated surgically and 289 patients (group B) were not treated. Liver resection, metastasectomy, pancreaticoduodenectomy, partial pancreatectomy, and regional lymph node dissection were performed on the patients in group A. The overall survival rate was statistically higher in group A (P = 0.001). Among the surgical procedures, resection of locoregional recurrences (except liver) in abdominal cavity (4.0 to 101.8 months vs. 0.6 to 71.6 months) and metastasectomy of abdominal or chest wall (3.5 to 18.9 months vs. 1.9 to 2.2 months) showed remarkable differences with respect to the range of survival.
CONCLUSION
Better survival outcomes can be expected by performing surgical resection of locoregional recurrences (except liver) in abdominal cavity and abdominal or chest wall metastatic lesions in recurrent cholangiocarcinoma.

Keyword

Recurrence; Range of survival; Cholangiocarcinoma; Radiofrequency ablation

MeSH Terms

Abdominal Cavity
Cholangiocarcinoma
Follow-Up Studies
Humans
Liver
Lymph Node Excision
Metastasectomy
Pancreatectomy
Pancreaticoduodenectomy
Recurrence
Survival Rate
Thoracic Wall

Figure

• 

  Fig. 1 Overall survival rate after recurrence according to surgical treatment and concurrent chemoradiotherapy (CCRT) for recurrent cholangiocarcinoma (group A; patients treated surgically for recurrence, group B; patients not treated, P-value between the two groups = 0.001).

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