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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

 Jung Ho Im  ;  Jinsil Seong  ;  Ik Jae Lee  ;  Joon Seong Park  ;  Dong Sup Yoon  ;  Kyung Sik Kim  ;  Woo Jung Lee  ;  Kyung Ran Park 
 CANCER RESEARCH AND TREATMENT, Vol.48(2) : 583-595, 2016 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Bile Ducts, Extrahepatic/drug effects ; Bile Ducts, Extrahepatic/pathology* ; Bile Ducts, Extrahepatic/radiation effects ; Bile Ducts, Extrahepatic/surgery* ; Biliary Tract Neoplasms/drug therapy ; Biliary Tract Neoplasms/radiotherapy ; Biliary Tract Neoplasms/surgery ; Biliary Tract Neoplasms/therapy* ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Survival Analysis ; Treatment Outcome
Adjuvant radiotherapy ; Biliary tract neoplasms ; Cholangiocarcinoma ; Drug therapy ; Extrahepatic bile duct cancer ; Survival
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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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kyung Sik(김경식) ORCID logo https://orcid.org/0000-0001-9498-284X
Park, Joon Seong(박준성) ORCID logo https://orcid.org/0000-0001-8048-9990
Seong, Jin Sil(성진실) ORCID logo https://orcid.org/0000-0003-1794-5951
Yoon, Dong Sup(윤동섭) ORCID logo https://orcid.org/0000-0001-6444-9606
Lee, Woo Jung(이우정) ORCID logo https://orcid.org/0000-0001-9273-261X
Lee, Ik Jae(이익재) ORCID logo https://orcid.org/0000-0001-7165-3373
Im, Jung Ho(임정호)
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