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Cholangiocellular cancer: the state of the problem and ways to improve the results of surgical treatmentстатья Исследовательская статья
Информация о цитировании статьи получена из
Scopus
Дата последнего поиска статьи во внешних источниках: 8 апреля 2022 г.
- Авторы: Patyutko Yu I., Polyakov A.N., Podluzhnyi D.V., Syskova A.Yu, Sagaidak I.V., Kotelnikov A.G., Sergeeva O.N., Pokataev I.A.
- Журнал: Khirurgiya. Zhurnal im. N.I. Pirogova
- Номер: 12
- Год издания: 2018
- Первая страница: 30
- Последняя страница: 37
- DOI: 10.17116/hirurgia201812130
- Аннотация: Aim — to improve the outcomes in patients with biliary cancer. Material and methods. There were 263 procedures for cholangiocellular carcinoma (HCC) for the period 1998—2017. Adjuvant chemotherapy was performed in 102 (38.8%) patients. Advanced liver resection (78.9%) prevailed for cholangiocellular carcinoma (n=128), 6 (4.7%) patients required vascular resection. Seventy-seven pancreaticoduodenectomies were applied for cancer of common bile duct, portal vein resection was necessary in 8 (10.4%) patients. In case of Klatskin tumor (n=58) liver resection combined with bile duct resection (n=52) prevailed. Portal vein resection was made in 16 (27.6%) patients. Results. Postoperative morbidity was 68 (53.1%), mortality — 5 (3.9%). Among patients with Klatskin tumor morbidity was 51 (87.9%), mortality — 6 (10.3%). In patients with common bile duct cancer morbidity was 53 (68.8%), mortality — 4 (5.2%). In overall group median was 30 months. R0-resection was followed by better long-term results (median 37 months) compared with R1—R2 resection (20 months; p=0.01). Lymph node involvement is associated with significantly worse prognosis (p=0.016), however 5-year survival is observed (25.6%). Adjuvant chemotherapy in R0-resection significantly improved long-term results: median was 46 months (vs. 30 in group without chemotherapy; p=0.02). In liver HCC patients, multiple lesions or mechanical jaundice did not aggravate long-term results. Conclusion. R0-resection including lymphadenectomy, resection of adjacent organs and vessels is advisable for HCC. Isolated bile duct resection should be used as an exception. Adjuvant therapy improved long-term results. Multiple lymph node lesion or bile duct infiltration are not contraindications to surgery in HCC patients.
- Добавил в систему: Поляков Александр Николаевич