This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS

Impact of intrapancreatic or extrapancreatic bile duct involvement on survival following pancreatoduodenectomy for common bile duct cancer. BJS 2014; 101: 89-99.

Published: 23rd December 2013

Authors: K. Kamposioras, A. Anthoney, C. Fernández Moro, A. Cairns, A. M. Smith, C. Liaskos et al.

Background

The clinicopathological factors that influence survival following pancreatoduodenectomy (PD) for common bile duct (CBD) cancer are not well known. This study aimed to investigate the effect of tumour involvement of the intrapancreatic versus extrapancreatic CBD on margin status, overall (OS) and disease‐free (DFS) survival.

Method

This was a retrospective study of patients who underwent PD for CBD cancer between 2001 and 2009. Pathological examination was performed according to a previously described standardized protocol based on axial slicing. Clinicopathological data and outcome in terms of margin status, DFS and OS were compared between cancers involving exclusively the intrapancreatic CBD (CBDin) and those involving the extrapancreatic CBD, in isolation or combined with invasion of the intrapancreatic part of the duct (CBDex).

Results

A total of 66 patients were enrolled. Most CBD cancers were locally advanced (97 per cent pathological (p) T3, 76 per cent pN1). Microscopic margin involvement (R1) was more frequent in CBDex than in CBDin cancers (34 of 39 versus 13 of 27; P = 0·001), more often multifocal (P < 0·001) and more frequently affected the periductal margin (P = 0·005). Venous resection was more often required for CBDex cancers (P = 0·009). CBDex cancers were associated with worse OS (median 21 versus 28 months; P = 0·020) and DFS (14 versus 31 months; P = 0·015), but the rate and site of recurrence did not differ. Metastasis to more than two lymph nodes was an independent predictor of OS and DFS.

Conclusion

CBDex cancer is associated with a higher rate of R1 resection and venous resection after PD, and has a worse outcome than CBDin cancer.

Full text

You may also be interested in

Systematic review

Systematic review of functional outcome and quality of life after total pancreatectomy.

Authors: L. Scholten, T. F. Stoop, M. Del Chiaro, O. R. Busch, C. van Eijck, I. Q. Molenaar et al.

Systematic review

Meta‐analysis of recurrence pattern after resection for pancreatic cancer.

Authors: M. Tanaka, A. L. Mihaljevic, P. Probst, M. Heckler, U. Klaiber, U. Heger et al.

Original article

Multicentre observational cohort study of implementation and outcomes of laparoscopic distal pancreatectomy.

Authors: S. Lof, A. L. Moekotte, B. Al‐Sarireh, B. Ammori, S. Aroori, D. Durkin et al.

Original article

Multicentre analysis of the learning curve for laparoscopic liver resection of the posterosuperior segments. BJS 2019; 106: 1512-1522.

Authors: G. Berardi, D. Aghayan, Å. A. Fretland, H. Elberm, F. Cipriani, A. Spagnoli et al.

Original article

Validation of a nomogram to predict the risk of cancer in patients with intraductal papillary mucinous neoplasm and main duct dilatation of 10 mm or less.

Authors: W. Jung, T. Park, Y. Kim, H. Park, Y. Han, J. He et al.

Original article

Secondary technical resectability of colorectal cancer liver metastases after chemotherapy with or without selective internal radiotherapy in the randomized SIRFLOX trial.

Authors: B. Garlipp, P. Gibbs, G. A. Van Hazel, R. Jeyarajah, R. C. G. Martin, C. J. Bruns et al.

Original article

Benign hilar bile duct strictures resected as perihilar cholangiocarcinoma. BJS 2019; 106: 1504-1511.

Authors: S. Otsuka, T. Ebata, Y. Yokoyama, T. Igami, T. Mizuno, J. Yamaguchi et al.

Systematic review

Meta‐analysis of the association between primary tumour location and prognosis after surgical resection of colorectal liver metastases.

Authors: X.‐Y. Wang, R. Zhang, Z. Wang, Y. Geng, J. Lin, K. Ma et al.

Original article

Mortality after liver surgery in Germany. BJS 2019; 106: 1523-1529.

Authors: N. Filmann, D. Walter, E. Schadde, C. Bruns, T. Keck, H. Lang et al.

Original article

Quality of life from a randomized trial of laparoscopic or open liver resection for colorectal liver metastases. BJS 2019; 106: 1372-1380.

Authors: Å. A. Fretland, V. J. Dagenborg, G. M. Waaler Bjørnelv, D. L. Aghayan, A. M. Kazaryan, L. Barkhatov et al.

Original article

Safety and efficacy of transarterial embolization of hepatocellular adenomas. BJS 2019; 106: 1362-1371.

Authors: B. V. van Rosmalen, A. J. Klompenhouwer, J. Jaap de Graeff, M. P. D. Haring, V. E. de Meijer, L. Rifai et al.

Original article

Perioperative outcomes and long‐term quality of life after total pancreatectomy.

Authors: A. Pulvirenti, A. Pea, N. Rezaee, C. Gasparini, G. Malleo, M. J. Weiss et al.