Conversion surgery for initially unresectable locally advanced biliary tract cancer: A multicenter collaborative study conducted in Japan and Korea
Background Although surgical resection is the only curative treatment for biliary tract cancer, in some cases, the disease is diagnosed as unresectable at initial presentation. There are few reports of conversion surgery after the initial treatment for unresectable locally advanced biliary tract can...
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| Veröffentlicht in: | Journal of hepato-biliary-pancreatic sciences 2024-07, Vol.31 (7), p.481-491 |
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| creator | Yabushita, Yasuhiro Park, Joon Seong Yoon, Yoo‐Seok Ohtsuka, Masayuki Kwon, Wooil Choi, Gi Hong Imamura, Masafumi Matsumoto, Ippei Mizuno, Shugo Matsuyama, Ryusei Sakata, Jun Hayashi, Hiromitsu Takeda, Yutaka Katagiri, Satoshi Sugawara, Toshitaka Kobayashi, Shogo Kawasaki, Yota Nagano, Hiroaki Murase, Katsutoshi Kim, Hyung Sun Nah, Yang Won Jang, Jin‐Young Yamaue, Hiroki Yoon, Dong Sup Yamamoto, Masakazu Choi, Dongho Nakamura, Masafumi Kim, Ki‐Hun Endo, Itaru |
| description | Background
Although surgical resection is the only curative treatment for biliary tract cancer, in some cases, the disease is diagnosed as unresectable at initial presentation. There are few reports of conversion surgery after the initial treatment for unresectable locally advanced biliary tract cancer. This study aimed to evaluate the efficacy and safety of conversion surgery in patients with initially unresectable locally advanced biliary tract cancer.
Methods
We retrospectively collected clinical data from groups of patients in multiple centers belonging to the Japanese Society of Hepato‐Biliary‐Pancreatic Surgery and Korean Association of Hepato‐Biliary‐Pancreatic Surgery. We analyzed two groups of prognostic factors (pretreatment and surgical factors) and their relation to the treatment outcomes.
Results
A total of 56 patients with initially unresectable locally advanced biliary tract cancer were enrolled in this study of which 55 (98.2%) patients received chemotherapy, and 16 (28.6%) patients received additional radiation therapy. The median time from the start of the initial treatment to resection was 6.4 months. Severe postoperative complications of Clavien‐Dindo grade III or higher occurred in 34 patients (60.7%), and postoperative mortality occurred in five patients (8.9%). Postoperative histological results revealed CR in eight patients (14.3%). The median survival time from the start of the initial treatment in all 56 patients who underwent conversion surgery was 37.7 months, the 3‐year survival rate was 53.9%, and the 5‐year survival rate was 39.1%.
Conclusions
Conversion surgery for initially unresectable locally advanced biliary tract cancer may lead to longer survival in selected patients. However, more precise preoperative safety evaluation and careful postoperative management are required.
In this multicenter retrospective study conducted at Japanese and Korean hepatobiliary pancreatic centers, Yabushita and colleagues found that conversion surgery performed after preoperative treatment for initially unresectable locally advanced biliary tract cancer may lead to longer survival in selected patients. Improved preoperative safety evaluation and postoperative management, however, are warranted. |
| doi_str_mv | 10.1002/jhbp.1437 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3063465793</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3063465793</sourcerecordid><originalsourceid>FETCH-LOGICAL-c2437-abf56e329b0e78aea1bde6ccecde9cf2f90b3992ac982ca0db0160652e9724ec3</originalsourceid><addsrcrecordid>eNp1kc1uEzEUhS0EolXpghdAltjAIq1_JjNjdiUCSqkEC1iPru074Mixg3-C8hy8ME5TukDibmwdfT66PoeQ55xdcMbE5fqH3l7wTg6PyCkf-3HRq1E8frgP3Qk5z3nN2kgulWRPyYkcR9FmOCW_VzHsMGUXA801fce0p3NM1AVXHHi_pzUkzGgKaI_UR3Mngt1BMGipdt5Be1MSmELNQUxv6BXdVF-cwVAwURO9Bx0TFLdDmku1-6YFW01pDi7QG9hCoBAs_RQTwjPyZAaf8fz-PCPf3r_7urpe3H7-8HF1dbswon13AXpe9iiF0gyHERC4ttgbg8aiMrOYFdNSKQGmBWKAWc14z_qlQDWIDo08I6-OvtsUf1bMZdq4bLAtGzDWPEnWy65fDko29OU_6DrWFNp2jRo73i1bmo16faRMijknnKdtcpsWz8TZdChrOpQ1Hcpq7It7x6o3aB_Iv9U04PII_HIe9_93mm6u3365s_wDL2WiBA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3084145227</pqid></control><display><type>article</type><title>Conversion surgery for initially unresectable locally advanced biliary tract cancer: A multicenter collaborative study conducted in Japan and Korea</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Yabushita, Yasuhiro ; Park, Joon Seong ; Yoon, Yoo‐Seok ; Ohtsuka, Masayuki ; Kwon, Wooil ; Choi, Gi Hong ; Imamura, Masafumi ; Matsumoto, Ippei ; Mizuno, Shugo ; Matsuyama, Ryusei ; Sakata, Jun ; Hayashi, Hiromitsu ; Takeda, Yutaka ; Katagiri, Satoshi ; Sugawara, Toshitaka ; Kobayashi, Shogo ; Kawasaki, Yota ; Nagano, Hiroaki ; Murase, Katsutoshi ; Kim, Hyung Sun ; Nah, Yang Won ; Jang, Jin‐Young ; Yamaue, Hiroki ; Yoon, Dong Sup ; Yamamoto, Masakazu ; Choi, Dongho ; Nakamura, Masafumi ; Kim, Ki‐Hun ; Endo, Itaru</creator><creatorcontrib>Yabushita, Yasuhiro ; Park, Joon Seong ; Yoon, Yoo‐Seok ; Ohtsuka, Masayuki ; Kwon, Wooil ; Choi, Gi Hong ; Imamura, Masafumi ; Matsumoto, Ippei ; Mizuno, Shugo ; Matsuyama, Ryusei ; Sakata, Jun ; Hayashi, Hiromitsu ; Takeda, Yutaka ; Katagiri, Satoshi ; Sugawara, Toshitaka ; Kobayashi, Shogo ; Kawasaki, Yota ; Nagano, Hiroaki ; Murase, Katsutoshi ; Kim, Hyung Sun ; Nah, Yang Won ; Jang, Jin‐Young ; Yamaue, Hiroki ; Yoon, Dong Sup ; Yamamoto, Masakazu ; Choi, Dongho ; Nakamura, Masafumi ; Kim, Ki‐Hun ; Endo, Itaru</creatorcontrib><description>Background
Although surgical resection is the only curative treatment for biliary tract cancer, in some cases, the disease is diagnosed as unresectable at initial presentation. There are few reports of conversion surgery after the initial treatment for unresectable locally advanced biliary tract cancer. This study aimed to evaluate the efficacy and safety of conversion surgery in patients with initially unresectable locally advanced biliary tract cancer.
Methods
We retrospectively collected clinical data from groups of patients in multiple centers belonging to the Japanese Society of Hepato‐Biliary‐Pancreatic Surgery and Korean Association of Hepato‐Biliary‐Pancreatic Surgery. We analyzed two groups of prognostic factors (pretreatment and surgical factors) and their relation to the treatment outcomes.
Results
A total of 56 patients with initially unresectable locally advanced biliary tract cancer were enrolled in this study of which 55 (98.2%) patients received chemotherapy, and 16 (28.6%) patients received additional radiation therapy. The median time from the start of the initial treatment to resection was 6.4 months. Severe postoperative complications of Clavien‐Dindo grade III or higher occurred in 34 patients (60.7%), and postoperative mortality occurred in five patients (8.9%). Postoperative histological results revealed CR in eight patients (14.3%). The median survival time from the start of the initial treatment in all 56 patients who underwent conversion surgery was 37.7 months, the 3‐year survival rate was 53.9%, and the 5‐year survival rate was 39.1%.
Conclusions
Conversion surgery for initially unresectable locally advanced biliary tract cancer may lead to longer survival in selected patients. However, more precise preoperative safety evaluation and careful postoperative management are required.
In this multicenter retrospective study conducted at Japanese and Korean hepatobiliary pancreatic centers, Yabushita and colleagues found that conversion surgery performed after preoperative treatment for initially unresectable locally advanced biliary tract cancer may lead to longer survival in selected patients. Improved preoperative safety evaluation and postoperative management, however, are warranted.</description><identifier>ISSN: 1868-6974</identifier><identifier>ISSN: 1868-6982</identifier><identifier>EISSN: 1868-6982</identifier><identifier>DOI: 10.1002/jhbp.1437</identifier><identifier>PMID: 38822227</identifier><language>eng</language><publisher>Japan: Wiley Subscription Services, Inc</publisher><subject>Adult ; Aged ; Aged, 80 and over ; biliary tract cancer ; Biliary Tract Neoplasms - mortality ; Biliary Tract Neoplasms - pathology ; Biliary Tract Neoplasms - surgery ; Biliary Tract Surgical Procedures - methods ; Cancer therapies ; Cholangiocarcinoma ; conversion surgery ; Female ; Humans ; Japan ; locally advanced ; Male ; Medical prognosis ; Middle Aged ; Neoplasm Staging ; Prognosis ; Republic of Korea ; Retrospective Studies ; Surgery ; Survival Rate ; Treatment Outcome ; unresectable</subject><ispartof>Journal of hepato-biliary-pancreatic sciences, 2024-07, Vol.31 (7), p.481-491</ispartof><rights>2024 Japanese Society of Hepato‐Biliary‐Pancreatic Surgery.</rights><rights>Copyright © 2024 Japanese Society of Hepato‐Biliary‐Pancreatic Surgery</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c2437-abf56e329b0e78aea1bde6ccecde9cf2f90b3992ac982ca0db0160652e9724ec3</cites><orcidid>0000-0003-1090-1614 ; 0000-0002-1593-3773 ; 0000-0002-2253-544X ; 0000-0001-5520-8114 ; 0000-0003-3965-3693 ; 0000-0002-8828-1067 ; 0000-0001-8048-9990 ; 0000-0001-7621-8557 ; 0000-0002-6982-3457</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fjhbp.1437$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fjhbp.1437$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38822227$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yabushita, Yasuhiro</creatorcontrib><creatorcontrib>Park, Joon Seong</creatorcontrib><creatorcontrib>Yoon, Yoo‐Seok</creatorcontrib><creatorcontrib>Ohtsuka, Masayuki</creatorcontrib><creatorcontrib>Kwon, Wooil</creatorcontrib><creatorcontrib>Choi, Gi Hong</creatorcontrib><creatorcontrib>Imamura, Masafumi</creatorcontrib><creatorcontrib>Matsumoto, Ippei</creatorcontrib><creatorcontrib>Mizuno, Shugo</creatorcontrib><creatorcontrib>Matsuyama, Ryusei</creatorcontrib><creatorcontrib>Sakata, Jun</creatorcontrib><creatorcontrib>Hayashi, Hiromitsu</creatorcontrib><creatorcontrib>Takeda, Yutaka</creatorcontrib><creatorcontrib>Katagiri, Satoshi</creatorcontrib><creatorcontrib>Sugawara, Toshitaka</creatorcontrib><creatorcontrib>Kobayashi, Shogo</creatorcontrib><creatorcontrib>Kawasaki, Yota</creatorcontrib><creatorcontrib>Nagano, Hiroaki</creatorcontrib><creatorcontrib>Murase, Katsutoshi</creatorcontrib><creatorcontrib>Kim, Hyung Sun</creatorcontrib><creatorcontrib>Nah, Yang Won</creatorcontrib><creatorcontrib>Jang, Jin‐Young</creatorcontrib><creatorcontrib>Yamaue, Hiroki</creatorcontrib><creatorcontrib>Yoon, Dong Sup</creatorcontrib><creatorcontrib>Yamamoto, Masakazu</creatorcontrib><creatorcontrib>Choi, Dongho</creatorcontrib><creatorcontrib>Nakamura, Masafumi</creatorcontrib><creatorcontrib>Kim, Ki‐Hun</creatorcontrib><creatorcontrib>Endo, Itaru</creatorcontrib><title>Conversion surgery for initially unresectable locally advanced biliary tract cancer: A multicenter collaborative study conducted in Japan and Korea</title><title>Journal of hepato-biliary-pancreatic sciences</title><addtitle>J Hepatobiliary Pancreat Sci</addtitle><description>Background
Although surgical resection is the only curative treatment for biliary tract cancer, in some cases, the disease is diagnosed as unresectable at initial presentation. There are few reports of conversion surgery after the initial treatment for unresectable locally advanced biliary tract cancer. This study aimed to evaluate the efficacy and safety of conversion surgery in patients with initially unresectable locally advanced biliary tract cancer.
Methods
We retrospectively collected clinical data from groups of patients in multiple centers belonging to the Japanese Society of Hepato‐Biliary‐Pancreatic Surgery and Korean Association of Hepato‐Biliary‐Pancreatic Surgery. We analyzed two groups of prognostic factors (pretreatment and surgical factors) and their relation to the treatment outcomes.
Results
A total of 56 patients with initially unresectable locally advanced biliary tract cancer were enrolled in this study of which 55 (98.2%) patients received chemotherapy, and 16 (28.6%) patients received additional radiation therapy. The median time from the start of the initial treatment to resection was 6.4 months. Severe postoperative complications of Clavien‐Dindo grade III or higher occurred in 34 patients (60.7%), and postoperative mortality occurred in five patients (8.9%). Postoperative histological results revealed CR in eight patients (14.3%). The median survival time from the start of the initial treatment in all 56 patients who underwent conversion surgery was 37.7 months, the 3‐year survival rate was 53.9%, and the 5‐year survival rate was 39.1%.
Conclusions
Conversion surgery for initially unresectable locally advanced biliary tract cancer may lead to longer survival in selected patients. However, more precise preoperative safety evaluation and careful postoperative management are required.
In this multicenter retrospective study conducted at Japanese and Korean hepatobiliary pancreatic centers, Yabushita and colleagues found that conversion surgery performed after preoperative treatment for initially unresectable locally advanced biliary tract cancer may lead to longer survival in selected patients. Improved preoperative safety evaluation and postoperative management, however, are warranted.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>biliary tract cancer</subject><subject>Biliary Tract Neoplasms - mortality</subject><subject>Biliary Tract Neoplasms - pathology</subject><subject>Biliary Tract Neoplasms - surgery</subject><subject>Biliary Tract Surgical Procedures - methods</subject><subject>Cancer therapies</subject><subject>Cholangiocarcinoma</subject><subject>conversion surgery</subject><subject>Female</subject><subject>Humans</subject><subject>Japan</subject><subject>locally advanced</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Middle Aged</subject><subject>Neoplasm Staging</subject><subject>Prognosis</subject><subject>Republic of Korea</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><subject>Survival Rate</subject><subject>Treatment Outcome</subject><subject>unresectable</subject><issn>1868-6974</issn><issn>1868-6982</issn><issn>1868-6982</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kc1uEzEUhS0EolXpghdAltjAIq1_JjNjdiUCSqkEC1iPru074Mixg3-C8hy8ME5TukDibmwdfT66PoeQ55xdcMbE5fqH3l7wTg6PyCkf-3HRq1E8frgP3Qk5z3nN2kgulWRPyYkcR9FmOCW_VzHsMGUXA801fce0p3NM1AVXHHi_pzUkzGgKaI_UR3Mngt1BMGipdt5Be1MSmELNQUxv6BXdVF-cwVAwURO9Bx0TFLdDmku1-6YFW01pDi7QG9hCoBAs_RQTwjPyZAaf8fz-PCPf3r_7urpe3H7-8HF1dbswon13AXpe9iiF0gyHERC4ttgbg8aiMrOYFdNSKQGmBWKAWc14z_qlQDWIDo08I6-OvtsUf1bMZdq4bLAtGzDWPEnWy65fDko29OU_6DrWFNp2jRo73i1bmo16faRMijknnKdtcpsWz8TZdChrOpQ1Hcpq7It7x6o3aB_Iv9U04PII_HIe9_93mm6u3365s_wDL2WiBA</recordid><startdate>202407</startdate><enddate>202407</enddate><creator>Yabushita, Yasuhiro</creator><creator>Park, Joon Seong</creator><creator>Yoon, Yoo‐Seok</creator><creator>Ohtsuka, Masayuki</creator><creator>Kwon, Wooil</creator><creator>Choi, Gi Hong</creator><creator>Imamura, Masafumi</creator><creator>Matsumoto, Ippei</creator><creator>Mizuno, Shugo</creator><creator>Matsuyama, Ryusei</creator><creator>Sakata, Jun</creator><creator>Hayashi, Hiromitsu</creator><creator>Takeda, Yutaka</creator><creator>Katagiri, Satoshi</creator><creator>Sugawara, Toshitaka</creator><creator>Kobayashi, Shogo</creator><creator>Kawasaki, Yota</creator><creator>Nagano, Hiroaki</creator><creator>Murase, Katsutoshi</creator><creator>Kim, Hyung Sun</creator><creator>Nah, Yang Won</creator><creator>Jang, Jin‐Young</creator><creator>Yamaue, Hiroki</creator><creator>Yoon, Dong Sup</creator><creator>Yamamoto, Masakazu</creator><creator>Choi, Dongho</creator><creator>Nakamura, Masafumi</creator><creator>Kim, Ki‐Hun</creator><creator>Endo, Itaru</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1090-1614</orcidid><orcidid>https://orcid.org/0000-0002-1593-3773</orcidid><orcidid>https://orcid.org/0000-0002-2253-544X</orcidid><orcidid>https://orcid.org/0000-0001-5520-8114</orcidid><orcidid>https://orcid.org/0000-0003-3965-3693</orcidid><orcidid>https://orcid.org/0000-0002-8828-1067</orcidid><orcidid>https://orcid.org/0000-0001-8048-9990</orcidid><orcidid>https://orcid.org/0000-0001-7621-8557</orcidid><orcidid>https://orcid.org/0000-0002-6982-3457</orcidid></search><sort><creationdate>202407</creationdate><title>Conversion surgery for initially unresectable locally advanced biliary tract cancer: A multicenter collaborative study conducted in Japan and Korea</title><author>Yabushita, Yasuhiro ; Park, Joon Seong ; Yoon, Yoo‐Seok ; Ohtsuka, Masayuki ; Kwon, Wooil ; Choi, Gi Hong ; Imamura, Masafumi ; Matsumoto, Ippei ; Mizuno, Shugo ; Matsuyama, Ryusei ; Sakata, Jun ; Hayashi, Hiromitsu ; Takeda, Yutaka ; Katagiri, Satoshi ; Sugawara, Toshitaka ; Kobayashi, Shogo ; Kawasaki, Yota ; Nagano, Hiroaki ; Murase, Katsutoshi ; Kim, Hyung Sun ; Nah, Yang Won ; Jang, Jin‐Young ; Yamaue, Hiroki ; Yoon, Dong Sup ; Yamamoto, Masakazu ; Choi, Dongho ; Nakamura, Masafumi ; Kim, Ki‐Hun ; Endo, Itaru</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2437-abf56e329b0e78aea1bde6ccecde9cf2f90b3992ac982ca0db0160652e9724ec3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>biliary tract cancer</topic><topic>Biliary Tract Neoplasms - mortality</topic><topic>Biliary Tract Neoplasms - pathology</topic><topic>Biliary Tract Neoplasms - surgery</topic><topic>Biliary Tract Surgical Procedures - methods</topic><topic>Cancer therapies</topic><topic>Cholangiocarcinoma</topic><topic>conversion surgery</topic><topic>Female</topic><topic>Humans</topic><topic>Japan</topic><topic>locally advanced</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Middle Aged</topic><topic>Neoplasm Staging</topic><topic>Prognosis</topic><topic>Republic of Korea</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><topic>Survival Rate</topic><topic>Treatment Outcome</topic><topic>unresectable</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yabushita, Yasuhiro</creatorcontrib><creatorcontrib>Park, Joon Seong</creatorcontrib><creatorcontrib>Yoon, Yoo‐Seok</creatorcontrib><creatorcontrib>Ohtsuka, Masayuki</creatorcontrib><creatorcontrib>Kwon, Wooil</creatorcontrib><creatorcontrib>Choi, Gi Hong</creatorcontrib><creatorcontrib>Imamura, Masafumi</creatorcontrib><creatorcontrib>Matsumoto, Ippei</creatorcontrib><creatorcontrib>Mizuno, Shugo</creatorcontrib><creatorcontrib>Matsuyama, Ryusei</creatorcontrib><creatorcontrib>Sakata, Jun</creatorcontrib><creatorcontrib>Hayashi, Hiromitsu</creatorcontrib><creatorcontrib>Takeda, Yutaka</creatorcontrib><creatorcontrib>Katagiri, Satoshi</creatorcontrib><creatorcontrib>Sugawara, Toshitaka</creatorcontrib><creatorcontrib>Kobayashi, Shogo</creatorcontrib><creatorcontrib>Kawasaki, Yota</creatorcontrib><creatorcontrib>Nagano, Hiroaki</creatorcontrib><creatorcontrib>Murase, Katsutoshi</creatorcontrib><creatorcontrib>Kim, Hyung Sun</creatorcontrib><creatorcontrib>Nah, Yang Won</creatorcontrib><creatorcontrib>Jang, Jin‐Young</creatorcontrib><creatorcontrib>Yamaue, Hiroki</creatorcontrib><creatorcontrib>Yoon, Dong Sup</creatorcontrib><creatorcontrib>Yamamoto, Masakazu</creatorcontrib><creatorcontrib>Choi, Dongho</creatorcontrib><creatorcontrib>Nakamura, Masafumi</creatorcontrib><creatorcontrib>Kim, Ki‐Hun</creatorcontrib><creatorcontrib>Endo, Itaru</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of hepato-biliary-pancreatic sciences</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yabushita, Yasuhiro</au><au>Park, Joon Seong</au><au>Yoon, Yoo‐Seok</au><au>Ohtsuka, Masayuki</au><au>Kwon, Wooil</au><au>Choi, Gi Hong</au><au>Imamura, Masafumi</au><au>Matsumoto, Ippei</au><au>Mizuno, Shugo</au><au>Matsuyama, Ryusei</au><au>Sakata, Jun</au><au>Hayashi, Hiromitsu</au><au>Takeda, Yutaka</au><au>Katagiri, Satoshi</au><au>Sugawara, Toshitaka</au><au>Kobayashi, Shogo</au><au>Kawasaki, Yota</au><au>Nagano, Hiroaki</au><au>Murase, Katsutoshi</au><au>Kim, Hyung Sun</au><au>Nah, Yang Won</au><au>Jang, Jin‐Young</au><au>Yamaue, Hiroki</au><au>Yoon, Dong Sup</au><au>Yamamoto, Masakazu</au><au>Choi, Dongho</au><au>Nakamura, Masafumi</au><au>Kim, Ki‐Hun</au><au>Endo, Itaru</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Conversion surgery for initially unresectable locally advanced biliary tract cancer: A multicenter collaborative study conducted in Japan and Korea</atitle><jtitle>Journal of hepato-biliary-pancreatic sciences</jtitle><addtitle>J Hepatobiliary Pancreat Sci</addtitle><date>2024-07</date><risdate>2024</risdate><volume>31</volume><issue>7</issue><spage>481</spage><epage>491</epage><pages>481-491</pages><issn>1868-6974</issn><issn>1868-6982</issn><eissn>1868-6982</eissn><abstract>Background
Although surgical resection is the only curative treatment for biliary tract cancer, in some cases, the disease is diagnosed as unresectable at initial presentation. There are few reports of conversion surgery after the initial treatment for unresectable locally advanced biliary tract cancer. This study aimed to evaluate the efficacy and safety of conversion surgery in patients with initially unresectable locally advanced biliary tract cancer.
Methods
We retrospectively collected clinical data from groups of patients in multiple centers belonging to the Japanese Society of Hepato‐Biliary‐Pancreatic Surgery and Korean Association of Hepato‐Biliary‐Pancreatic Surgery. We analyzed two groups of prognostic factors (pretreatment and surgical factors) and their relation to the treatment outcomes.
Results
A total of 56 patients with initially unresectable locally advanced biliary tract cancer were enrolled in this study of which 55 (98.2%) patients received chemotherapy, and 16 (28.6%) patients received additional radiation therapy. The median time from the start of the initial treatment to resection was 6.4 months. Severe postoperative complications of Clavien‐Dindo grade III or higher occurred in 34 patients (60.7%), and postoperative mortality occurred in five patients (8.9%). Postoperative histological results revealed CR in eight patients (14.3%). The median survival time from the start of the initial treatment in all 56 patients who underwent conversion surgery was 37.7 months, the 3‐year survival rate was 53.9%, and the 5‐year survival rate was 39.1%.
Conclusions
Conversion surgery for initially unresectable locally advanced biliary tract cancer may lead to longer survival in selected patients. However, more precise preoperative safety evaluation and careful postoperative management are required.
In this multicenter retrospective study conducted at Japanese and Korean hepatobiliary pancreatic centers, Yabushita and colleagues found that conversion surgery performed after preoperative treatment for initially unresectable locally advanced biliary tract cancer may lead to longer survival in selected patients. Improved preoperative safety evaluation and postoperative management, however, are warranted.</abstract><cop>Japan</cop><pub>Wiley Subscription Services, Inc</pub><pmid>38822227</pmid><doi>10.1002/jhbp.1437</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0003-1090-1614</orcidid><orcidid>https://orcid.org/0000-0002-1593-3773</orcidid><orcidid>https://orcid.org/0000-0002-2253-544X</orcidid><orcidid>https://orcid.org/0000-0001-5520-8114</orcidid><orcidid>https://orcid.org/0000-0003-3965-3693</orcidid><orcidid>https://orcid.org/0000-0002-8828-1067</orcidid><orcidid>https://orcid.org/0000-0001-8048-9990</orcidid><orcidid>https://orcid.org/0000-0001-7621-8557</orcidid><orcidid>https://orcid.org/0000-0002-6982-3457</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1868-6974 |
| ispartof | Journal of hepato-biliary-pancreatic sciences, 2024-07, Vol.31 (7), p.481-491 |
| issn | 1868-6974 1868-6982 1868-6982 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_3063465793 |
| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Adult Aged Aged, 80 and over biliary tract cancer Biliary Tract Neoplasms - mortality Biliary Tract Neoplasms - pathology Biliary Tract Neoplasms - surgery Biliary Tract Surgical Procedures - methods Cancer therapies Cholangiocarcinoma conversion surgery Female Humans Japan locally advanced Male Medical prognosis Middle Aged Neoplasm Staging Prognosis Republic of Korea Retrospective Studies Surgery Survival Rate Treatment Outcome unresectable |
| title | Conversion surgery for initially unresectable locally advanced biliary tract cancer: A multicenter collaborative study conducted in Japan and Korea |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-29T11%3A58%3A56IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Conversion%20surgery%20for%20initially%20unresectable%20locally%20advanced%20biliary%20tract%20cancer:%20A%20multicenter%20collaborative%20study%20conducted%20in%20Japan%20and%20Korea&rft.jtitle=Journal%20of%20hepato-biliary-pancreatic%20sciences&rft.au=Yabushita,%20Yasuhiro&rft.date=2024-07&rft.volume=31&rft.issue=7&rft.spage=481&rft.epage=491&rft.pages=481-491&rft.issn=1868-6974&rft.eissn=1868-6982&rft_id=info:doi/10.1002/jhbp.1437&rft_dat=%3Cproquest_cross%3E3063465793%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=3084145227&rft_id=info:pmid/38822227&rfr_iscdi=true |