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Time to Recurrence After Surgical Resection and Survival After Recurrence Among Patients with Perihilar and Distal Cholangiocarcinomas

  • Hepatobiliary Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The differences between perihilar cholangiocarcinoma (PHCC) and distal cholangiocarcinoma (DCC) regarding recurrence and the factors that affect recurrence after surgery are unclear. This study aims to investigate the differences in recurrence patterns between patients with PHCC and those with DCC after surgical resection with curative intent. It also investigates the risk factors associated with recurrence and survival thereafter.

Patients and Methods

The postoperative courses of 366 patients with extrahepatic cholangiocarcinomas (EHCCs), including 236 with PHCC and 130 with DCC, who underwent surgical resections were investigated retrospectively.

Results

During follow-up, tumors recurred in 143 (60.6%) patients with PHCC and in 72 (55.4%) patients with DCC. Overall survival (OS) after surgery, recurrence-free survival (RFS), and OS after recurrence were similar for the patients with PHCC and those with DCC. The cumulative probability of recurrence declined 3 years after surgery in the patients with PHCC and those with DCC. A multivariable analysis determined that, among the patients with PHCC and those with DCC, regional lymph node metastasis was a significant risk factor associated with RFS. Ten patients with PHCC and eight patients with DCC with two or fewer sites of recurrence in a single organ underwent resections. A multivariable analysis determined that recurrent tumor resection was an independent prognostic factor associated with OS after recurrence in the patients with PHCC and those with DCC.

Conclusions

Postoperative survival did not differ between the patients with PHCC and those with DCC. Frequent surveillances for recurrence are needed for 3 years after surgical resection of EHCCs. In selected patients, surgery for recurrent EHCCs might be associated with improved outcomes.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery II, Faculty of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan

    Yoshitsugu Nakanishi MD, PhD, Keisuke Okamura MD, PhD, Takahiro Tsuchikawa MD, PhD, Toru Nakamura MD, PhD, Takehiro Noji MD, PhD, Toshimichi Asano MD, PhD, Aya Matsui MD, PhD, Kimitaka Tanaka MD, PhD, Soichi Murakami MD, PhD, Yuma Ebihara MD, PhD, Yo Kurashima MD, PhD, Hajime Narasaki MD, PhD, Toshiaki Shichinohe MD, PhD & Satoshi Hirano MD, PhD

  2. Clinical Research and Medical Innovation Centre, Hokkaido University Hospital, Sapporo, Japan

    Toraji Amano MD, PhD

Authors
  1. Yoshitsugu Nakanishi MD, PhD
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  2. Keisuke Okamura MD, PhD
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  3. Takahiro Tsuchikawa MD, PhD
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  4. Toru Nakamura MD, PhD
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  5. Takehiro Noji MD, PhD
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  6. Toshimichi Asano MD, PhD
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  7. Aya Matsui MD, PhD
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  8. Kimitaka Tanaka MD, PhD
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  9. Soichi Murakami MD, PhD
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  10. Yuma Ebihara MD, PhD
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  11. Yo Kurashima MD, PhD
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  12. Hajime Narasaki MD, PhD
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  13. Toraji Amano MD, PhD
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  14. Toshiaki Shichinohe MD, PhD
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  15. Satoshi Hirano MD, PhD
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Corresponding author

Correspondence to Yoshitsugu Nakanishi MD, PhD.

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Nakanishi, Y., Okamura, K., Tsuchikawa, T. et al. Time to Recurrence After Surgical Resection and Survival After Recurrence Among Patients with Perihilar and Distal Cholangiocarcinomas. Ann Surg Oncol 27, 4171–4180 (2020). https://doi.org/10.1245/s10434-020-08534-2

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  • DOI: https://doi.org/10.1245/s10434-020-08534-2

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