ID | 60781 |
FullText URL | |
Author |
Kojima, Toru
Department of Surgery, Okayama Saiseikai General Hospital
Fuji, Tomokazu
Department of Surgery, Okayama Saiseikai General Hospital
Niguma, Takefumi
Department of Surgery, Okayama Saiseikai General Hospital
Satoh, Daisuke
Department of surgery, Hiroshima City Hiroshima Citizens Hospital
Endo, Yoshikatsu
Department of Surgery, Himeji Japanese Red Cross Hospital
Sui, Kenta
Department of Gastroenterological Surgery at Kochi Health Sciences Center
Inagaki, Masaru
Department of Surgery, National Hospital Organization Fukuyama Medical Center
Oishi, Masahiro
Department of Surgery, Tottori Municipal Hospital
Ota, Tetsuya
Department of Surgery, National Hospital Organization Okayama Medical Center
Hioki, Katsuyoshi
Department of Surgery, Fukuyama City Hospital
Matsuda, Tadakazu
Department of Surgery, Tenwakai Matsuda Hospital
Aoki, Hideki
Department of Surgery, National Hospital Organization Iwakuni Medical Center
Hirai, Ryuji
Department of Surgery, Himeji Saint Mary’s Hospital
Kimura, Masashi
Department of Surgery, Matsuyama City Hospital
Yagi, Takahito
Department of Gastroenterological Surgery, Okayama University
Kaken ID
publons
researchmap
Fujiwara, Toshiyoshi
Department of Gastroenterological Surgery, Okayama University
ORCID
Kaken ID
publons
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Abstract | Background The prognosis of intrahepatic cholangiocarcinoma (ICC) has been poor, because of the high recurrence rate even after curative surgery. This study aimed to evaluate the prognostic impact of surgical resection of recurrent ICC. Patients and methods A total of 345 cases of ICC who underwent hepatectomy with curative intent in 17 institutions were retrospectively analyzed, focusing on recurrence patterns and treatment modalities for recurrent ICC. Results Median survival time and overall 5-year recurrence-free survival rate were 17.8 months and 28.5%, respectively. Recurrences (n = 223) were classified as early (recurrence at <= 1 year, n = 131) or late (recurrence at >1 year, n = 92). Median survival time was poorer for early recurrence (16.3 months) than for late recurrence (47.7 months,p<0.0001). Treatment modalities for recurrence comprised surgical resection (n = 28), non-surgical treatment (n = 134), and best supportive care (BSC) (n = 61). Median and overall 1-/5-year survival rates after recurrence were 39.5 months and 84.6%/36.3% for surgical resection, 14.3 months and 62.5%/2.9% for non-surgical treatment, and 3 months and 4.8%/0% for BSC, respectively (p<0.0001). Multivariate analysis identified early recurrence, simultaneous intra- and extrahepatic recurrence, and surgical resection of recurrence as significant prognostic factors. In subgroup analyses, surgical resection may have positive prognostic impacts on intra- and extrahepatic recurrences, and even on early recurrence. However, simultaneous intra- and extrahepatic recurrence may not see any survival benefit from surgical management. Conclusion Surgical resection of recurrent ICC could improve survival after recurrence, especially for patients with intra- or extrahepatic recurrence as resectable oligo-metastases.
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Published Date | 2020-09-03
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Publication Title |
PLOS ONE
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Volume | volume15
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Issue | issue9
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Publisher | PUBLIC LIBRARY SCIENCE
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Start Page | e0238392
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ISSN | 1932-6203
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Content Type |
Journal Article
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language |
English
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OAI-PMH Set |
岡山大学
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Copyright Holders | © 2020 Kojima et al.
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File Version | publisher
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PubMed ID | |
DOI | |
Web of Science KeyUT | |
Related Url | isVersionOf https://doi.org/10.1371/journal.pone.0238392
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License | https://creativecommons.org/licenses/by/4.0/
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Funder Name |
Japan Society for the Promotion of Science
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助成番号 | 19K09217
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