論文

国際誌
2020年10月10日

Stratification of Postoperative Prognosis by Invasive Tumor Thickness in Perihilar Cholangiocarcinoma.

Annals of surgical oncology
  • Mitsunobu Oba
  • ,
  • Yoshitsugu Nakanishi
  • ,
  • Toraji Amano
  • ,
  • Keisuke Okamura
  • ,
  • Takahiro Tsuchikawa
  • ,
  • Toru Nakamura
  • ,
  • Takehiro Noji
  • ,
  • Toshimichi Asano
  • ,
  • Kimitaka Tanaka
  • ,
  • Satoshi Hirano

記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1245/s10434-020-09135-9

BACKGROUND: The pathological tumor classification of distal cholangiocarcinoma in the American Joint Committee on Cancer (AJCC) Cancer Staging Manual 8th edition is based on invasive depth, whereas that of perihilar cholangiocarcinoma (PHCC) continues to be layer-based. We aimed to clarify whether invasive depth measurement based on invasive tumor thickness (ITT) could help determine postoperative prognosis in patients with PHCC. METHODS: We enrolled 184 patients with PHCC who underwent hepatectomy plus extrahepatic bile duct resection or hepatopancreatoduodenectomy with curative intent. ITT was measured using simple definitions according to the sectioning direction or gross tumor pattern. RESULTS: The median ITT was 5.8 mm (range 0.7-15.5). Using the recursive partitioning technique, ITT was classified into grades A (ITT < 2 mm, n = 9), B (2 mm ≤ ITT < 5 mm, n = 68), C (5 mm ≤ ITT < 11 mm, n = 81), and D (11 mm < ITT, n = 26). The median survival times (MSTs) in patients with grade B, C, or D were 90.8, 44.6, and 21.1 months, respectively (patients with grade A did not reach the MST). There were significant differences in postoperative prognosis between ITT grades (A vs. B, p = 0.027; B vs. C, p < 0.001; C vs. D, p = 0.004). Through multivariate analysis, regional node metastasis, invasive carcinoma at the resected margin, and ITT grade were determined as independent prognostic factors. CONCLUSION: ITT could be measured using simple methods and may be used to stratify postoperative prognosis in patients with PHCC.

リンク情報
DOI
https://doi.org/10.1245/s10434-020-09135-9
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/33040247

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