Surgery alone versus surgery followed by chemotherapy and radiotherapy in resected extrahepatic bile duct cancer: Treatment outcome analysis of 336 patients

Jung Ho Im, Jinsil Seong, Ik Jae Lee, Joon Seong Park, Dong Sup Yoon, Kyung Sik Kim, Woo Jung Lee, Kyung Ran Park

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21 Citations (Scopus)

Abstract

Purpose This study analyzed the outcomes of patients with resected extrahepatic bile duct cancer (EHBDC) in order to clarify the role of adjuvant treatments in these patients. Materials and Methods A total of 336 patients with EHBDC who underwent curative resection between 2001 and 2010 were analyzed retrospectively. The treatment types were as follows: Surgery alone (n=168), surgery with chemotherapy (CTx, n=90), surgery with radiotherapy (RT) alone (n=29), and surgery with chemoradiotherapy (CRT, n=49). Results The median follow-up period was 63 months. The 5-year rates of locoregional failure-free survival (LRFFS), distant metastasis-free survival (DMFS), progression-free survival (PFS), and overall survival (OS) for all patients were 56.5%, 59.7%, 36.6%, and 42.0%, respectively. In multivariate analysis, surgery with RT and CRT was a significant prognostic factor for LRFFS, and surgery with CTx was a significant prognostic factor for DMFS, and surgery with CTx, RT, and CRT was a significant prognostic factor for PFS (p < 0.05). Surgery with CTx and CRT showed association with superior OS (p < 0.05), and surgery with RT had marginal significance (p=0.078). In multivariate analysis of the R1 resection patients, surgery with CRT showed significant association with OS (p < 0.05). Conclusion Adjuvant RT and CTx may be helpful in improving clinical outcomes of patients with resected EHBDC who have a high risk of disease recurrence, particularly R1 resection patients. Conduct of additional prospective, larger-scale studies will be required in order to confirm the benefit of adjuvant RT and CTx in these patients.

Original languageEnglish
Pages (from-to)583-595
Number of pages13
JournalCancer Research and Treatment
Volume48
Issue number2
DOIs
Publication statusPublished - 2016 Apr 1

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Bile Duct Neoplasms
Extrahepatic Bile Ducts
Radiotherapy
Drug Therapy
Survival
Adjuvant Radiotherapy
Disease-Free Survival
Multivariate Analysis
Neoplasm Metastasis
Chemoradiotherapy
Outcome Assessment (Health Care)

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Im, Jung Ho ; Seong, Jinsil ; Lee, Ik Jae ; Park, Joon Seong ; Yoon, Dong Sup ; Kim, Kyung Sik ; Lee, Woo Jung ; Park, Kyung Ran. / Surgery alone versus surgery followed by chemotherapy and radiotherapy in resected extrahepatic bile duct cancer : Treatment outcome analysis of 336 patients. In: Cancer Research and Treatment. 2016 ; Vol. 48, No. 2. pp. 583-595.
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title = "Surgery alone versus surgery followed by chemotherapy and radiotherapy in resected extrahepatic bile duct cancer: Treatment outcome analysis of 336 patients",
abstract = "Purpose This study analyzed the outcomes of patients with resected extrahepatic bile duct cancer (EHBDC) in order to clarify the role of adjuvant treatments in these patients. Materials and Methods A total of 336 patients with EHBDC who underwent curative resection between 2001 and 2010 were analyzed retrospectively. The treatment types were as follows: Surgery alone (n=168), surgery with chemotherapy (CTx, n=90), surgery with radiotherapy (RT) alone (n=29), and surgery with chemoradiotherapy (CRT, n=49). Results The median follow-up period was 63 months. The 5-year rates of locoregional failure-free survival (LRFFS), distant metastasis-free survival (DMFS), progression-free survival (PFS), and overall survival (OS) for all patients were 56.5{\%}, 59.7{\%}, 36.6{\%}, and 42.0{\%}, respectively. In multivariate analysis, surgery with RT and CRT was a significant prognostic factor for LRFFS, and surgery with CTx was a significant prognostic factor for DMFS, and surgery with CTx, RT, and CRT was a significant prognostic factor for PFS (p < 0.05). Surgery with CTx and CRT showed association with superior OS (p < 0.05), and surgery with RT had marginal significance (p=0.078). In multivariate analysis of the R1 resection patients, surgery with CRT showed significant association with OS (p < 0.05). Conclusion Adjuvant RT and CTx may be helpful in improving clinical outcomes of patients with resected EHBDC who have a high risk of disease recurrence, particularly R1 resection patients. Conduct of additional prospective, larger-scale studies will be required in order to confirm the benefit of adjuvant RT and CTx in these patients.",
author = "Im, {Jung Ho} and Jinsil Seong and Lee, {Ik Jae} and Park, {Joon Seong} and Yoon, {Dong Sup} and Kim, {Kyung Sik} and Lee, {Woo Jung} and Park, {Kyung Ran}",
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Surgery alone versus surgery followed by chemotherapy and radiotherapy in resected extrahepatic bile duct cancer : Treatment outcome analysis of 336 patients. / Im, Jung Ho; Seong, Jinsil; Lee, Ik Jae; Park, Joon Seong; Yoon, Dong Sup; Kim, Kyung Sik; Lee, Woo Jung; Park, Kyung Ran.

In: Cancer Research and Treatment, Vol. 48, No. 2, 01.04.2016, p. 583-595.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Surgery alone versus surgery followed by chemotherapy and radiotherapy in resected extrahepatic bile duct cancer

T2 - Treatment outcome analysis of 336 patients

AU - Im, Jung Ho

AU - Seong, Jinsil

AU - Lee, Ik Jae

AU - Park, Joon Seong

AU - Yoon, Dong Sup

AU - Kim, Kyung Sik

AU - Lee, Woo Jung

AU - Park, Kyung Ran

PY - 2016/4/1

Y1 - 2016/4/1

N2 - Purpose This study analyzed the outcomes of patients with resected extrahepatic bile duct cancer (EHBDC) in order to clarify the role of adjuvant treatments in these patients. Materials and Methods A total of 336 patients with EHBDC who underwent curative resection between 2001 and 2010 were analyzed retrospectively. The treatment types were as follows: Surgery alone (n=168), surgery with chemotherapy (CTx, n=90), surgery with radiotherapy (RT) alone (n=29), and surgery with chemoradiotherapy (CRT, n=49). Results The median follow-up period was 63 months. The 5-year rates of locoregional failure-free survival (LRFFS), distant metastasis-free survival (DMFS), progression-free survival (PFS), and overall survival (OS) for all patients were 56.5%, 59.7%, 36.6%, and 42.0%, respectively. In multivariate analysis, surgery with RT and CRT was a significant prognostic factor for LRFFS, and surgery with CTx was a significant prognostic factor for DMFS, and surgery with CTx, RT, and CRT was a significant prognostic factor for PFS (p < 0.05). Surgery with CTx and CRT showed association with superior OS (p < 0.05), and surgery with RT had marginal significance (p=0.078). In multivariate analysis of the R1 resection patients, surgery with CRT showed significant association with OS (p < 0.05). Conclusion Adjuvant RT and CTx may be helpful in improving clinical outcomes of patients with resected EHBDC who have a high risk of disease recurrence, particularly R1 resection patients. Conduct of additional prospective, larger-scale studies will be required in order to confirm the benefit of adjuvant RT and CTx in these patients.

AB - Purpose This study analyzed the outcomes of patients with resected extrahepatic bile duct cancer (EHBDC) in order to clarify the role of adjuvant treatments in these patients. Materials and Methods A total of 336 patients with EHBDC who underwent curative resection between 2001 and 2010 were analyzed retrospectively. The treatment types were as follows: Surgery alone (n=168), surgery with chemotherapy (CTx, n=90), surgery with radiotherapy (RT) alone (n=29), and surgery with chemoradiotherapy (CRT, n=49). Results The median follow-up period was 63 months. The 5-year rates of locoregional failure-free survival (LRFFS), distant metastasis-free survival (DMFS), progression-free survival (PFS), and overall survival (OS) for all patients were 56.5%, 59.7%, 36.6%, and 42.0%, respectively. In multivariate analysis, surgery with RT and CRT was a significant prognostic factor for LRFFS, and surgery with CTx was a significant prognostic factor for DMFS, and surgery with CTx, RT, and CRT was a significant prognostic factor for PFS (p < 0.05). Surgery with CTx and CRT showed association with superior OS (p < 0.05), and surgery with RT had marginal significance (p=0.078). In multivariate analysis of the R1 resection patients, surgery with CRT showed significant association with OS (p < 0.05). Conclusion Adjuvant RT and CTx may be helpful in improving clinical outcomes of patients with resected EHBDC who have a high risk of disease recurrence, particularly R1 resection patients. Conduct of additional prospective, larger-scale studies will be required in order to confirm the benefit of adjuvant RT and CTx in these patients.

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