Surgical Resection for Pulmonary Metastasis From Cholangiocarcinoma: A Retrospective Case Series.

INTRODUCTION

Cholangiocarcinoma (CCA) is associated with a high incidence of recurrence and patients occasionally develop pulmonary metastases. Systemic chemotherapy is the first-line treatment for unresectable or recurrent CCA. However, we have occasionally encountered cases of favorable prognosis following pulmonary resection for CCA metastases.

MATERIALS AND

METHODS

Data from patients undergoing surgery for CCA between 2012 and 2021 were obtained from a prospectively maintained database. We retrospectively reviewed patients with pulmonary metastases from CCA, including those who underwent pulmonary resection and those who did not. Additionally, we described a representative case of repeated pulmonary resection with long-term survival.

RESULTS

Among 122 patients who underwent surgery for CCA with curative intent, 64 patients (52.5%) experienced recurrence, including 14 patients (11.5%) who developed pulmonary metastases. Of these, five underwent pulmonary resection, including 1 who received two resections. None of the patients experienced postoperative complications. With a median follow-up of 2.6 y, three patients remained alive without recurrence. A representative case achieved long-term survival after repeated pulmonary resections. The 5-y overall survival rates were significantly better in patients who underwent pulmonary resection than in those who did not (75.0% versus 0%, P = 0.011).

CONCLUSIONS

Pulmonary resection may represent a feasible treatment option for carefully selected patients with pulmonary metastases from CCA.