胆管癌患者肺部复发的预后影响

Prognostic impact of lung recurrence in patients with biliary tract cancer.

作者信息

Sumiyoshi Tatsuaki, Uemura Kenichiro, Shintakuya Ryuta, Okada Kenjiro, Serikawa Masahiro, Ishii Yasutaka, Arihiro Koji, Murakami Yoshiaki, Murashita Jyunji, Takahashi Shinya

机构信息

Department of Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.

Department of Gastroenterology and Metabolism, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan.

出版信息

Langenbecks Arch Surg. 2023 Jul 31;408(1):290. doi: 10.1007/s00423-023-03015-y.

DOI:10.1007/s00423-023-03015-y

PMID:37522989

Abstract

PURPOSE

This study aimed to evaluate the prognostic impact of the initial recurrence site following resection for biliary tract carcinoma (BTC), focusing on lung recurrence.

METHODS

The clinical data of patients with recurrent BTC who underwent curative intent surgery between March 2009 and December 2021 were retrospectively analyzed. The prognosis of patients with recurrent BTC was investigated in each recurrence site. Eligible patients were classified into two groups according to lung or non-lung recurrence. Clinicopathological factors, survival after recurrence, and overall survival were compared between the two groups. Independent factors associated with survival after recurrence were investigated using multivariate analysis.

RESULTS

Of 119 patients, the initial recurrence site was local in 26 (21.8%) patients, liver in 19 (16.8%), peritoneum in 14 (11.8%), lymph node in 12 (10.1%), lung in 11 (9.2%), multiple organs in 32 (26.9%), and others in 5 (4.2%). The survival period after recurrence in patients with lung recurrence was significantly longer than those in patients with other six recurrence patterns. The median survival after recurrence was 34.3 and 9.3 months in lung recurrence and non-lung recurrence groups, respectively (p < 0.0001); that after initial surgery was 50.8 and 26.4 months, respectively (p = 0.0383). Multivariate analysis revealed that lung recurrence and normal albumin level at recurrence were independently associated with survival after recurrence (Hazard Ratio (HR), 0.291; p = 0.0128; HR, 0.476; p = 0.00126, respectively).

CONCLUSIONS

Survival period after recurrence was significantly longer in patients with lung recurrence.

摘要

目的

本研究旨在评估胆管癌（BTC）切除术后初始复发部位的预后影响，重点关注肺复发情况。

方法

回顾性分析2009年3月至2021年12月期间接受根治性手术的复发性BTC患者的临床资料。对复发性BTC患者在每个复发部位的预后进行研究。符合条件的患者根据肺复发或非肺复发分为两组。比较两组之间的临床病理因素、复发后的生存率和总生存率。使用多变量分析研究与复发后生存相关的独立因素。

结果

119例患者中，初始复发部位为局部的有26例（21.8%），肝脏19例（16.8%），腹膜14例（11.8%），淋巴结12例（10.1%），肺11例（9.2%），多器官32例（26.9%），其他5例（4.2%）。肺复发患者复发后的生存期明显长于其他六种复发模式的患者。肺复发组和非肺复发组复发后的中位生存期分别为34.3个月和9.3个月（p<0.0001）；初次手术后分别为50.8个月和26.4个月（p=0.0383）。多变量分析显示，肺复发和复发时白蛋白水平正常与复发后生存独立相关（风险比（HR）分别为0.291；p=0.0128；HR为0.476；p=0.00126）。