Tohmatsu Yuuko, Ohgi Katsuhisa, Ashida Ryo, Yamada Mihoko, Otsuka Shimpei, Kato Yoshiyasu, Uesaka Katsuhiko, Sugiura Teiichi
Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, Shizuoka, Japan.
Ann Surg Oncol. 2025 Mar;32(3):1808-1816. doi: 10.1245/s10434-024-16628-4. Epub 2024 Dec 4.
The impact of time to surgery (TTS) on survival in patients with perihilar cholangiocarcinoma (PHC) is uncertain.
Data from PHC patients scheduled for surgery between 2011 and 2020 were reviewed. Patients were grouped based on the median TTS, defined as the time from diagnosis to surgery. Survival outcomes were analyzed for all patients and those undergoing potentially curative resection (resection without distant metastasis).
Of 224 patients, the median TTS was 64 days (range 19-212), with the patients being divided into two groups: long-TTS group (TTS ≥64 days, n = 116) and short-TTS group (TTS <64 days, n = 108). The long-TTS group showed higher rates of preoperative biliary infection (52% vs. 33%; p = 0.004) and portal vein embolization (84% vs. 49%; p < 0.001) compared with the short-TTS group. Forty-seven patients (18%) had unresectable tumors or distant metastasis, with a median overall survival (OS) of 18 months. The rate of potentially curative resection tended to be lower in the long-TTS group (74%) compared with the short-TTS group (84%), although it was not statistically significant (p = 0.063). However, OS for the entire cohort was comparable between the long-TTS and short-TTS groups (median OS 40 vs. 36 months; p = 0.986). Multivariable analysis revealed that TTS was not associated with survival in patients who underwent potentially curative resection.
Although the potentially curative resection rate tended to be lower in the long-TTS group, TTS did not impact survival in patients undergoing potentially curative resection for PHC.
手术时间（TTS）对肝门部胆管癌（PHC）患者生存的影响尚不确定。
回顾了2011年至2020年间计划接受手术的PHC患者的数据。根据中位TTS将患者分组，中位TTS定义为从诊断到手术的时间。分析了所有患者以及接受潜在根治性切除术（无远处转移的切除术）患者的生存结果。
224例患者中，中位TTS为64天（范围19 - 212天），患者被分为两组：长TTS组（TTS≥64天，n = 116）和短TTS组（TTS < 64天，n = 108）。与短TTS组相比，长TTS组术前胆道感染率（52%对33%；p = 0.004）和门静脉栓塞率（84%对49%；p < 0.001）更高。47例患者（18%）有不可切除的肿瘤或远处转移，中位总生存期（OS）为18个月。长TTS组潜在根治性切除率（74%）与短TTS组（84%）相比有降低趋势，尽管差异无统计学意义（p = 0.063）。然而，长TTS组和短TTS组整个队列的OS相当（中位OS分别为40个月和36个月；p = 0.986）。多变量分析显示，TTS与接受潜在根治性切除术患者的生存无关。
尽管长TTS组潜在根治性切除率有降低趋势，但TTS对接受PHC潜在根治性切除术患者的生存无影响。
