Spread of lymph node metastasis and adjuvant therapy for distal cholangiocarcinoma
Spread of lymph node metastasis and adjuvant therapy for distal cholangiocarcinoma
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远端胆管癌的淋巴结转移及辅助治疗
DOI：
10.1007/s10147-022-02175-z
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发表时间：
2022
影响因子：
3.3
通讯作者：
Ohtsuka Takao
中科院分区：
文献类型：
--
作者：
Kurahara Hiroshi;Mataki Yuko;Idichi Tetsuya;Kawasaki Yota;Mori Shinichiro;Sasaki Ken;Arigami Takaaki;Nakajo Akihiro;Fukukura Yoshihiko;Higashi Michiyo;Ohtsuka Takao
淋巴结转移是远端胆管癌的主要转移途径。本研究的目的是阐明淋巴结（LN）转移的模式和LN的清扫和术后辅助化疗的有效性在DCC patients.MethodsPatients谁接受手术切除根治性的意图DCC参加。LN站的命名根据日本肝胆胰外科学会指南定义。每一个站的淋巴结清扫的有效性计算使用频率的淋巴结转移到车站和5年生存率的患者淋巴结转移到station.Results105例纳入研究，46（43.8%）有淋巴结转移，43（41.0%）进行术后辅助治疗。LN转移、血清CA 19-9> 37 U/mL、胆管切缘阳性是总生存期缩短的独立危险因素。手术时最常见的转移性LN是13号（32.7%），其次是12号（19.2%）、17号（9.6%）和8号（6.6%）。8号、14号和16号工作站的LN分离无效。在淋巴结转移患者中，术后辅助化疗与OS延长显著相关，而在导管切缘阳性或血清CA 19-9水平> 37 U/mL的患者中，术后辅助化疗与OS延长无关。然而，需要更有效的治疗策略来改善具有其他不良预后因素的患者的预后。
BackgroundLymphatic metastasis is a major route of metastasis in distal cholangiocarcinoma (DCC). The present study aimed to elucidate the pattern of lymph node (LN) metastasis and the effectiveness of LN dissection and postoperative adjuvant chemotherapy in patients with DCC.MethodsPatients who underwent surgical resection with curative intent for DCC were enrolled. The nomenclature of the LN stations was defined according to the Japanese Society of Hepato-Biliary-Pancreatic Surgery guidelines. Effectiveness of LN dissection of each station was calculated using frequency of LN metastasis to the station and 5-year survival rate of patients with LN metastasis to that station.ResultsOf the 105 patients included in the study, 46 (43.8%) had LN metastasis, and 43 (41.0%) underwent postoperative adjuvant therapy. LN metastasis, serum carbohydrate antigen (CA) 19–9 level > 37 U/mL, and positive bile duct margin were independent risk factors for shorter overall survival (OS). The most common metastatic LN station at surgery was No. 13 (32.7%), followed by No. 12 (19.2%), No. 17 (9.6%), and No. 8 (6.6%). There was no effectiveness of LN dissection of the station No. 8, 14, and 16. Adjuvant chemotherapy was significantly associated with longer OS in patients with LN metastasis but not in those with positive ductal margins or serum CA 19–9 level > 37 U/mL.ConclusionsPostoperative adjuvant chemotherapy was associated with a better prognosis in patients with DCC and LN metastasis. However, a more effective therapeutic strategy is required to improve the prognosis of patients with other negative prognostic factors.
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胆管癌的新辅助化疗与辅助化疗：倾向评分匹配分析。
DOI：
10.1093/annonc/mdy282.146
发表时间：
2018
期刊：
Annals of oncology : official journal of the European Society for Medical Oncology
影响因子：
--
作者：
S. Yadav;H. Xie;I. Riaz;Pankaj Sharma;A. Mahipal;R. McWilliams
通讯作者：
R. McWilliams
CHIJIIWA，Kazuo.：Arch.Biochim.Biophys。
DOI：
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发表时间：
--
期刊：
影响因子：
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作者：
通讯作者：
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影响因子：
3.7
作者：
Murakami, Yoshiaki;Uemura, Kenichiro;Sueda, Taijiro
通讯作者：
Sueda, Taijiro
影响因子：
9.6
作者：
Ebata, T.;Hirano, S.;Nagino, M.
通讯作者：
Nagino, M.
影响因子：
9.6
作者：
Murakami, Y.;Satoi, S.;Honda, G.
通讯作者：
Honda, G.