Peri-hilar cholangiocarcinoma: results from the UK nationwide CAPBIL study.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
McClements Jane, Koh Amanda, Sellappan Harivinthan, Blackburn Lauren, Brooks Adam, Clements Jake, Merali Nabeel, Frampton Adam, Gulbahar Syeda, Davidson Brian, Almomani Eyas, Bartlett David, Papadopoulos Georgios, Karavias Dimitrios, Rowcroft Alistair, Lucocq James, Harrison Ewen M, Morrison-Jones Victoria, Welsh Fenella, Pathanki Adithya, Marangoni Gabriele, Bruno Paris, Skipworth James, Spiers Harry, Kosmoliaptsis Vasilis, Gilbert Timothy, Malik Hassan, Vijayashanker Aarathi, Menon Krishna, Patel Waqqas, Bekheit Mohammed, Tanno Lulu, Silva Michael, Brown Christopher, Kumar Nagappan, Triance Joel, Shah Nehal, Alsaoudi Tareq, Bhardwaj Neil, Nassar Hussein, Mownah Omar, Yeung Derek, Bhogal Ricky, Blanco-Colino Ruth, Farid Shahid, Aljaberi Rami, Pandanaboyana Sanjay, Abdelmohsin Omar, Aroori Somaiah, Evans Daisy, Athwal Tejinderjit, Lodge Peter, Gomez Dhanwant, UK HPB Research Collaborative Group, United Kingdom
Аннотация
METHODS: Patients undergoing resection for pCCA between 2014 and 2022 across 22 UK centres were included. Early-stage pCCA was defined as tumour size<3cm with no nodal disease (N0) on histopathology analysis. Clinical and survival data were collated.
RESULTS: Of the 450 patients included, 138 patients underwent resection for early-stage pCCA. In the early-stage pCCA group, CD ≥ IIIa morbidity was 39.1 % (n = 54) and 90-day mortality was 10.1 % (n = 14). Sixty-four (46.4 %) patients received adjuvant chemotherapy, but this was reduced in those with CD ≥ IIIa morbidity (n = 17, 31.5 %). Early-stage tumours had a significantly lower vascular invasion (n = 57, 41.3 %) and R1 margin (n = 46, 33.3 %) compared to later-stage pCCA [62.2 % (n = 194) and 54.2 % (n = 169) respectively, p < 0.001). The median disease-free and overall survival was significantly better in patients with early-stage pCCA compared to more advanced tumours (p < 0.001). Male gender (p = 0.039) and Post-Hepatectomy Liver Failure (PHLF, p = 0.010) were associated with significantly worse disease-free survival, while biliary drainage (p = 0.013), PHLF (p < 0.001) and vascular invasion (p = 0.030) were associated with significantly poorer overall survival.
CONCLUSION: Resection of early-stage pCCA tumours is associated with good clinical and survival outcomes in centralised HPB centres.