HPB : the official journal of the International Hepato Pancreato Biliary Association · 2025
Oncologic impact of perineural invasion in perihilar cholangiocarcinoma: an international multicenter study.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Kawashima Jun, Akabane Miho, Tsilimigras Diamantis I, Woldesenbet Selamawit, Khalil Mujtaba, Endo Yutaka, Sahara Kota, Aucejo Federico, Marques Hugo P, Chumbinho Beatriz, Hugh Tom, Maithel Shishir K, Groot Koerkamp Bas, Ruzzenente Andrea, Endo Itaru, Pawlik Timothy M
Аннотация
BACKGROUND: We sought to evaluate the prognostic significance of perineural invasion (PNI) among patients undergoing curative-intent resection for perihilar cholangiocarcinoma (pCCA), with a specific focus on early-stage disease.
METHODS: Data from patients who underwent curative-intent resection for pCCA were collected from eight high-volume international hepatobiliary centers. The association between PNI status, clinicopathological features, and long-term survival was analyzed in both the overall cohort and a subset of patients with early-stage pCCA.
RESULTS: Among 435 patients, 364 (83.7 %) were PNI-positive. At the time of surgery, 53 patients with PNI underwent margin re-resection; only 19 (35.8 %) achieved a final R0 margin, whereas 34 (64.2 %) had a persistent R1 margin on the final pathological examination. PNI was independently associated with worse overall survival in the entire cohort (HR 1.52), as well as among patients with T1/2 (HR 1.53) and node-negative (HR 1.60) disease. Although not associated with improved survival among node-negative patients, adjuvant chemotherapy provided a survival benefit among patients with node-negative disease who had PNI (50.8 months vs. 28.6 months; p = 0.044).
CONCLUSION: PNI was an independent predictor of long-term survival, particularly among patients with early-stage pCCA.
METHODS: Data from patients who underwent curative-intent resection for pCCA were collected from eight high-volume international hepatobiliary centers. The association between PNI status, clinicopathological features, and long-term survival was analyzed in both the overall cohort and a subset of patients with early-stage pCCA.
RESULTS: Among 435 patients, 364 (83.7 %) were PNI-positive. At the time of surgery, 53 patients with PNI underwent margin re-resection; only 19 (35.8 %) achieved a final R0 margin, whereas 34 (64.2 %) had a persistent R1 margin on the final pathological examination. PNI was independently associated with worse overall survival in the entire cohort (HR 1.52), as well as among patients with T1/2 (HR 1.53) and node-negative (HR 1.60) disease. Although not associated with improved survival among node-negative patients, adjuvant chemotherapy provided a survival benefit among patients with node-negative disease who had PNI (50.8 months vs. 28.6 months; p = 0.044).
CONCLUSION: PNI was an independent predictor of long-term survival, particularly among patients with early-stage pCCA.
Предметные рубрики MeSH
HumansMaleFemaleBile Duct NeoplasmsNeoplasm InvasivenessKlatskin TumorMiddle AgedAgedTreatment OutcomeMargins of ExcisionTime FactorsNeoplasm StagingRisk FactorsRetrospective StudiesKaplan-Meier EstimateHepatectomyChemotherapy, AdjuvantPeripheral NervesProportional Hazards ModelsAdultHospitals, High-VolumeAged, 80 and over