Extrahepatic Bile Duct Adenocarcinoma

Background Patients with resected extrahepatic bile duct adenocarcinoma who have microscopically positive resection margins and/or pathologic locoregional nodal involvement (R1pN1) have a high-risk of locoregional recurrence, and therefore, we advocate the use of adjuvant chemoradiation. To evaluate...

وصف كامل

محفوظ في:
التفاصيل البيبلوغرافية
المؤلف الرئيسي: Borghero, Yerko (author)
مؤلفون آخرون: Crane, Christopher (author), Szklaruk, Janio (author), Oyarzo, Mauricio (author), Curley, Steven (author), Pisters, Peter (author), Evans, Douglas (author), Abdalla, Eddie (author), Thomas, Melanie (author), Das, Prajnan (author), Wistuba, Ignacio (author), Krishnan, Sunil (author), Vauthey, Nicolas (author)
التنسيق: article
منشور في: 2008
الوصول للمادة أونلاين:http://hdl.handle.net/10725/2585
http://dx.doi.org/10.1245/s10434-008-9998-7
http://link.springer.com/article/10.1245/s10434-008-9998-7
الوسوم: إضافة وسم
لا توجد وسوم, كن أول من يضع وسما على هذه التسجيلة!
_version_ 1864513458665422848
author Borghero, Yerko
author2 Crane, Christopher
Szklaruk, Janio
Oyarzo, Mauricio
Curley, Steven
Pisters, Peter
Evans, Douglas
Abdalla, Eddie
Thomas, Melanie
Das, Prajnan
Wistuba, Ignacio
Krishnan, Sunil
Vauthey, Nicolas
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author_facet Borghero, Yerko
Crane, Christopher
Szklaruk, Janio
Oyarzo, Mauricio
Curley, Steven
Pisters, Peter
Evans, Douglas
Abdalla, Eddie
Thomas, Melanie
Das, Prajnan
Wistuba, Ignacio
Krishnan, Sunil
Vauthey, Nicolas
author_role author
dc.creator.none.fl_str_mv Borghero, Yerko
Crane, Christopher
Szklaruk, Janio
Oyarzo, Mauricio
Curley, Steven
Pisters, Peter
Evans, Douglas
Abdalla, Eddie
Thomas, Melanie
Das, Prajnan
Wistuba, Ignacio
Krishnan, Sunil
Vauthey, Nicolas
dc.date.none.fl_str_mv 2008
2015-11-16T12:50:44Z
2015-11-16T12:50:44Z
2015-11-16
dc.identifier.none.fl_str_mv 1068-9265
http://hdl.handle.net/10725/2585
http://dx.doi.org/10.1245/s10434-008-9998-7
Borghero, Y., Crane, C. H., Szklaruk, J., Oyarzo, M., Curley, S., Pisters, P. W., ... & Vauthey, J. N. (2008). Extrahepatic bile duct adenocarcinoma: patients at high-risk for local recurrence treated with surgery and adjuvant chemoradiation have an equivalent overall survival to patients with standard-risk treated with surgery alone. Annals of surgical oncology, 15(11), 3147-3156.
http://link.springer.com/article/10.1245/s10434-008-9998-7
dc.language.none.fl_str_mv en
dc.relation.none.fl_str_mv Gastrointestinal Oncology
dc.rights.*.fl_str_mv info:eu-repo/semantics/openAccess
dc.title.none.fl_str_mv Extrahepatic Bile Duct Adenocarcinoma
Patients at High-Risk for Local Recurrence Treated with Surgery and Adjuvant Chemoradiation Have an Equivalent Overall Survival to Patients with Standard-Risk Treated with Surgery Alone
dc.type.none.fl_str_mv Article
info:eu-repo/semantics/publishedVersion
info:eu-repo/semantics/article
description Background Patients with resected extrahepatic bile duct adenocarcinoma who have microscopically positive resection margins and/or pathologic locoregional nodal involvement (R1pN1) have a high-risk of locoregional recurrence, and therefore, we advocate the use of adjuvant chemoradiation. To evaluate the safety and effectiveness of this treatment, we compared survival and side effects outcomes between such patients and patients with negative resection margins and pathologically negative nodes (R0pN0) who did not receive adjuvant treatment. Methods Between 1984 and 2005, 65 patients were treated with curative-intended resection for extrahepatic bile duct adenocarcinoma. Patients with tumors arising in the gallbladder and periampullary region were excluded. Pathology and diagnostic images were centrally reviewed. Overall survival and locoregional recurrence outcomes for patients with standard-risk R0pN0 (surgery alone, or S group, n = 23) were compared with those of patients with high locoregional recurrence risk, R1 and/or pN1 (R1pN1) status who received adjuvant chemoradiation (S-CRT group, n = 42). Results The median follow-up for the entire group was 31 months. Patients in the S-CRT and S groups had a similar 5-year overall survival (36% vs. 42%, P = .6) and locoregional recurrence (5-year rate: 38% vs. 37%, P = .13). In the S-CRT group, three patients (7%) experienced an acute (grade 3 or more) side effect. Conclusions Our finding of a lack of a survival difference between the S and S-CRT groups suggests that for patients with extrahepatic bile duct adenocarcinoma at high risk for locoregional recurrence (i.e., R1 resection or pN1 disease), adjuvant chemoradiation provides an equivalent overall survival despite of these worse prognostic features.
eu_rights_str_mv openAccess
format article
id LAURepo_974b005aefcec7dd7e69f7265eeea7a8
identifier_str_mv 1068-9265
Borghero, Y., Crane, C. H., Szklaruk, J., Oyarzo, M., Curley, S., Pisters, P. W., ... & Vauthey, J. N. (2008). Extrahepatic bile duct adenocarcinoma: patients at high-risk for local recurrence treated with surgery and adjuvant chemoradiation have an equivalent overall survival to patients with standard-risk treated with surgery alone. Annals of surgical oncology, 15(11), 3147-3156.
language_invalid_str_mv en
network_acronym_str LAURepo
network_name_str Lebanese American University repository
oai_identifier_str oai:laur.lau.edu.lb:10725/2585
publishDate 2008
repository.mail.fl_str_mv
repository.name.fl_str_mv
repository_id_str
spelling Extrahepatic Bile Duct AdenocarcinomaPatients at High-Risk for Local Recurrence Treated with Surgery and Adjuvant Chemoradiation Have an Equivalent Overall Survival to Patients with Standard-Risk Treated with Surgery AloneBorghero, YerkoCrane, ChristopherSzklaruk, JanioOyarzo, MauricioCurley, StevenPisters, PeterEvans, DouglasAbdalla, EddieThomas, MelanieDas, PrajnanWistuba, IgnacioKrishnan, SunilVauthey, NicolasBackground Patients with resected extrahepatic bile duct adenocarcinoma who have microscopically positive resection margins and/or pathologic locoregional nodal involvement (R1pN1) have a high-risk of locoregional recurrence, and therefore, we advocate the use of adjuvant chemoradiation. To evaluate the safety and effectiveness of this treatment, we compared survival and side effects outcomes between such patients and patients with negative resection margins and pathologically negative nodes (R0pN0) who did not receive adjuvant treatment. Methods Between 1984 and 2005, 65 patients were treated with curative-intended resection for extrahepatic bile duct adenocarcinoma. Patients with tumors arising in the gallbladder and periampullary region were excluded. Pathology and diagnostic images were centrally reviewed. Overall survival and locoregional recurrence outcomes for patients with standard-risk R0pN0 (surgery alone, or S group, n = 23) were compared with those of patients with high locoregional recurrence risk, R1 and/or pN1 (R1pN1) status who received adjuvant chemoradiation (S-CRT group, n = 42). Results The median follow-up for the entire group was 31 months. Patients in the S-CRT and S groups had a similar 5-year overall survival (36% vs. 42%, P = .6) and locoregional recurrence (5-year rate: 38% vs. 37%, P = .13). In the S-CRT group, three patients (7%) experienced an acute (grade 3 or more) side effect. Conclusions Our finding of a lack of a survival difference between the S and S-CRT groups suggests that for patients with extrahepatic bile duct adenocarcinoma at high risk for locoregional recurrence (i.e., R1 resection or pN1 disease), adjuvant chemoradiation provides an equivalent overall survival despite of these worse prognostic features.PublishedN/A2015-11-16T12:50:44Z2015-11-16T12:50:44Z20082015-11-16Articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article1068-9265http://hdl.handle.net/10725/2585http://dx.doi.org/10.1245/s10434-008-9998-7Borghero, Y., Crane, C. H., Szklaruk, J., Oyarzo, M., Curley, S., Pisters, P. W., ... & Vauthey, J. N. (2008). Extrahepatic bile duct adenocarcinoma: patients at high-risk for local recurrence treated with surgery and adjuvant chemoradiation have an equivalent overall survival to patients with standard-risk treated with surgery alone. Annals of surgical oncology, 15(11), 3147-3156.http://link.springer.com/article/10.1245/s10434-008-9998-7enGastrointestinal Oncologyinfo:eu-repo/semantics/openAccessoai:laur.lau.edu.lb:10725/25852019-02-26T08:27:40Z
spellingShingle Extrahepatic Bile Duct Adenocarcinoma
Borghero, Yerko
status_str publishedVersion
title Extrahepatic Bile Duct Adenocarcinoma
title_full Extrahepatic Bile Duct Adenocarcinoma
title_fullStr Extrahepatic Bile Duct Adenocarcinoma
title_full_unstemmed Extrahepatic Bile Duct Adenocarcinoma
title_short Extrahepatic Bile Duct Adenocarcinoma
title_sort Extrahepatic Bile Duct Adenocarcinoma
url http://hdl.handle.net/10725/2585
http://dx.doi.org/10.1245/s10434-008-9998-7
http://link.springer.com/article/10.1245/s10434-008-9998-7