Soonchunhyang Med Sci.  2016 Jun;22(1):1-7. 10.0000/sms.2016.22.1.1.

Metastasectomy for Recurrent or Metastatic Biliary Tract Cancers: A Single Center Experience

• Kim J
• Jang Y
• Shim J
• Yu J
• Shin DB
• Park I

• KMID: 2328771
• DOI: http://doi.org/10.0000/sms.2016.22.1.1

Abstract

OBJECTIVE
Efficacy or long-term result of metastasectomy for recurrent or metastatic biliary tract carcinoma (BTC) is not well established. We conducted a retrospective review of the outcomes of metastasectomy for recurrent or metastatic BTCs.
METHODS
The clinicopathological features and outcomes of consecutive patients with BTCs who underwent surgical resection for primary and metastatic disease at a tertiary referral hospital from 2003 to 2013 were reviewed retrospectively.
RESULTS
We found 19 eligible patients. Median age of patients was 57 years old (range, 27 to 68 years old), and 11 patients (58%) were female. Primary sites were gallbladder cancer (seven patients, 37%), intrahepatic cholangiocarcinoma (five patients, 26%), distal common bile duct cancer (three patients, 16%), proximal common bile duct cancer (two patients, 11%), and ampulla of Vater cancer (two patients, 11%). Eight patients (42%) had synchronous metastasis, while 11 (58%) had metachronous metastasis. The most common metastatic site was liver (nine patients, 47%), lymph node (nine patients, 47%), and peritoneum (three patients, 16%). Nine patients (47%) achieved R0 resection, while four (21%) and six (32%) patients had R1 and R2 resection, respectively. With a median follow-up period of 26.7 months, the estimated median overall survival (OS) was 18.2 months (95% confidence interval [CI], 13.6 to 22.9 months). Lower Eastern Cooperative Oncology Group performance status (P=0.023), metachronous metastasis (P=0.04), absence of lymph node metastasis (P=0.009), lower numbers of metastatic organs (P<0.001), normal postoperative carbohydrate antigen 19-9 level (P=0.034), and time from diagnosis to metastasectomy more than one year (P=0.019) were identified as prognostic factors for a longer OS after metastasectomy.
CONCLUSION
For recurrent or metastatic BTCs, metastasectomy can be a viable option for selected patients.

Keyword

Biliary tract neoplasms; Neoplasm metastasis; Metastasectomy; Prognosis

MeSH Terms

Ampulla of Vater
Biliary Tract Neoplasms*
Biliary Tract*
Cholangiocarcinoma
Common Bile Duct
Diagnosis
Female
Follow-Up Studies
Gallbladder Neoplasms
Humans
Liver
Lymph Nodes
Metastasectomy*
Neoplasm Metastasis
Peritoneum
Prognosis
Retrospective Studies
Tertiary Care Centers