medigraphic.com

2019, Número 5

<< Anterior Siguiente >>

Cir Cir 2019; 87 (5)


Factores asociados a la sobrevida en pacientes operados por colangiocarcinoma hiliar con intención curativa

Contreras T, Pacheco S, Briceño E, Martínez J, Guerra JF, Jarufe N

Idioma: Español
Referencias bibliográficas: 38
Paginas: 508-515
Archivo PDF: 222.22 Kb.


RESUMEN

Objetivo: Determinar la sobrevida a largo plazo y analizar los factores asociados a esta en pacientes operados por colangiocarcinoma hiliar (CH) con intención curativa. Método: Estudio de cohorte no concurrente. Se incluyeron todos los pacientes sometidos a cirugía con intención curativa por CH entre 2002 y 2016. Se realizó un análisis de los factores asociados a la sobrevida mediante Kaplan Meier, test de log-rank y regresión de Cox. Se consideró significativo un valor de p ‹ 0.05. Resultados: Se operaron 30 pacientes. La mediana de edad fue de 65.5 años (rango: 33-84); 24 (80%) fueron de sexo masculino. El margen quirúrgico resultó negativo en 27 (90%) pacientes. Veintiún (70%) pacientes presentaron complicaciones y 3 (10%) fallecieron en el posoperatorio. Las sobrevidas al año, a 5 años y a 10 años fueron del 65.7%, el 37.3% y el 16.6%, respectivamente. En el análisis multivariable, el único factor asociado a la sobrevida fue el estadio T (hazard ratio: 0.309; intervalo de confianza del 95%: 0.101-0.942; p = 0.03). Discusión: Los pacientes operados por CH con intención curativa en nuestro centro presentan una adecuada sobrevida a largo plazo, con una elevada morbimortalidad posoperatoria. El único factor que se asoció a la sobrevida fue el estadio T.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Soares KC, Kamel I, Cosgrove DP, Herman JM, Pawlik TM. Hilar cholangiocarcinoma: diagnosis, treatment options, and management. Hepatobiliary Surg Nutr. 2014;3:18-34.

  2. Ramia JM. Hilar cholangiocarcinoma. World J Gastrointest Oncol. 2013; 5:113-4.

  3. Bhardwaj N, Garcea G, Dennison AR, Maddern GJ. The surgical management of Klatskin tumours: has anything changed in the last decade? World J Surg. 2015;39:2748-56.

  4. DeOliveira ML, Cunningham SC, Cameron JL, Kamangar F, Winter JM, Lillemoe KD, et al. Cholangiocarcinoma. Ann Surg. 2007;245:755-62.

  5. Zaydfudim VM, Rosen CB, Nagorney DM. Hilar cholangiocarcinoma. Surg Oncol Clin N Am. 2014;23:247-63.

  6. Groot Koerkamp B, Wiggers JK, Gonen M, Doussot A, Allen PJ, Besselink MGH, et al. Survival after resection of perihilar cholangiocarcinoma — development and external validation of a prognostic nomogram. Ann Oncol. 2015;26:1930-5.

  7. Wiggers JK, Groot Koerkamp B, Cieslak KP, Doussot A, van Klaveren D, Allen PJ, et al. Postoperative mortality after liver resection for perihilar cholangiocarcinoma: development of a risk score and importance of biliary drainage of the future liver remnant. J Am Coll Surg. 2016;223:321-31.e1.

  8. Strasberg SM. Resection of hilar cholangiocarcinoma. HPB Surg. 1998;10:415-8.

  9. Saxena A, Chua TC, Chu FC, Morris DL. Improved outcomes after aggressive surgical resection of hilar cholangiocarcinoma: a critical analysis of recurrence and survival. Am J Surg. 2011;202:310-20.

  10. Brown KM, Geller DA. Proximal biliary tumors. Surg Clin North Am. 2014;94:311-23.

  11. Bismuth H, Corlette MB. Intrahepatic cholangioenteric anastomosis in carcinoma of the hilus of the liver. Surg Gynecol Obstet. 1975;140:170‑8.

  12. Dindo D, Demartines N, Clavien PA. Classification of surgical complications. Ann Surg. 2004;240:205-13.

  13. Rahbari NN, Garden OJ, Padbury R, Brooke-Smith M, Crawford M, Adam R, et al. Posthepatectomy liver failure: a definition and grading by the International Study Group of Liver Surgery (ISGLS). Surgery. 2011; 149:713-24.

  14. Hasegawa S, Ikai I, Fujii H, Hatano E, Shimahara Y. Surgical resection of hilar cholangiocarcinoma: analysis of survival and postoperative complications. World J Surg. 2007;31:1256-63.

  15. Yubin L, Chihua F, Zhixiang J, Jinrui O, Zixian L, Jianghua Z, et al. Surgical management and prognostic factors of hilar cholangiocarcinoma: experience with 115 cases in China. Ann Surg Oncol. 2008;15:2113‑9.

  16. Groot Koerkamp B, Wiggers JK, Allen PJ, Besselink MG, Blumgart LH, Busch ORC, et al. Recurrence rate and pattern of perihilar cholangiocarcinoma after curative intent resection. J Am Coll Surg. 2015; 221:1041-9.

  17. Rea DJ, Muñoz-Juárez M, Farnell MB, Donohue JH, Que FG, Crownhart B, et al. Major hepatic resection for hilar cholangiocarcinoma. Arch Surg. 2004;139:514.

  18. Lai EC, Mok FP, Fan ST, Lo CM, Chu KM, Liu CL, et al. Preoperative endoscopic drainage for malignant obstructive jaundice. Br J Surg. 1994;81:1195-8.

  19. Laurent A, Tayar C, Cherqui D. Cholangiocarcinoma: preoperative biliary drainage (Con). HPB (Oxford). 2008;10:126-9.

  20. Sakata J, Shirai Y, Wakai T, Nomura T, Sakata E, Hatakeyama K. Catheter tract implantation metastases associated with percutaneous biliary drainage for extrahepatic cholangiocarcinoma. World J Gastroenterol. 2005;11:7024-7.

  21. Liu F, Li Y, Wei Y, Li B. Preoperative biliary drainage before resection for hilar cholangiocarcinoma: whether or not? A systematic review. Dig Dis Sci. 2011;56:663-72.

  22. Jarnagin WR, Fong Y, DeMatteo RP, Gonen M, Burke EC, Bodniewicz BS, et al. Staging, resectability, and outcome in 225 patients with hilar cholangiocarcinoma. Ann Surg. 2001;234:507-17-9.

  23. Matsuo K, Rocha FG, Ito K, D’Angelica MI, Allen PJ, Fong Y, et al. The Blumgart preoperative staging system for hilar cholangiocarcinoma: analysis of resectability and outcomes in 380 patients. J Am Coll Surg. 2012;215:343-55.

  24. Lim JH, Choi GH, Choi SH, Kim KS, Choi JS, Lee WJ. Liver resection for Bismuth type I and type II hilar cholangiocarcinoma. World J Surg. 2013;37:829-37.

  25. Song SC, Choi DW, Kow AW-C, Choi SH, Heo JS, Kim WS, et al. Surgical outcomes of 230 resected hilar cholangiocarcinoma in a single centre. ANZ J Surg. 2013;83:268-74.

  26. Cannon RM, Brock G, Buell JF. Surgical resection for hilar cholangiocarcinoma: experience improves resectability. HPB (Oxford). 2012;14:142-9.

  27. Hemming AW, Mekeel K, Khanna A, Baquerizo A, Kim RD. Portal vein resection in management of hilar cholangiocarcinoma. J Am Coll Surg. 2011;212 604-13.

  28. Tamoto E, Hirano S, Tsuchikawa T, Tanaka E, Miyamoto M, Matsumoto J, et al. Portal vein resection using the no-touch technique with a hepatectomy for hilar cholangiocarcinoma. HPB (Oxford). 2014;16:56-61.

  29. Dumitrascu T, Chirita D, Ionescu M, Popescu I. Resection for hilar cholangiocarcinoma: analysis of prognostic factors and the impact of systemic inflammation on long-term outcome. J Gastrointest Surg. 2013; 17:913-24.

  30. Miyazaki M, Kato A, Ito H, Kimura F, Shimizu H, Ohtsuka M, et al. Combined vascular resection in operative resection for hilar cholangiocarcinoma: does it work or not? Surgery. 2007;141 581-8.

  31. Kawasaki S, Imamura H, Kobayashi A, Noike T, Miwa S, Miyagawa S. Results of surgical resection for patients with hilar bile duct cancer. Ann Surg. 2003;238:84-92.

  32. Young AL, Prasad KR, Toogood GJ, Lodge JPA. Surgical treatment of hilar cholangiocarcinoma in a new era: comparison among leading Eastern and Western centers, Leeds. J Hepatobiliary Pancreat Sci. 2010;17:497-504.

  33. Ratti F, Cipriani F, Ferla F, Catena M, Paganelli M, Aldrighetti LAM. Hilar cholangiocarcinoma: preoperative liver optimization with multidisciplinary approach. Toward a better outcome. World J Surg. 2013;37:1388‑96.

  34. Seyama Y, Kubota K, Sano K, Noie T, Takayama T, Kosuge T, et al. Long-term outcome of extended hemihepatectomy for hilar bile duct cancer with no mortality and high survival rate. Ann Surg. 2003;238:73‑83.

  35. Ito F, Agni R, Rettammel RJ, Been MJ, Cho CS, Mahvi DM, et al. Resection of hilar cholangiocarcinoma. Ann Surg. 2008;248:273-9.

  36. Ramacciato G, Nigri G, Bellagamba R, Petrucciani N, Ravaioli M, Cescon M, et al. Univariate and multivariate analysis of prognostic factors in the surgical treatment of hilar cholangiocarcinoma. Am Surg. 2010; 76:1260‑8.

  37. Dinant S, Gerhards MF, Busch ORC, Obertop H, Gouma DJ, Van Gulik TM. The importance of complete excision of the caudate lobe in resection of hilar cholangiocarcinoma. HPB (Oxford). 2005;7:263-7.

  38. De Jong MC, Marques H, Clary BM, Bauer TW, Marsh JW, Ribero D, et al. The impact of portal vein resection on outcomes for hilar cholangiocarcinoma: a multi-institutional analysis of 305 cases. Cancer. 2012; 118:4737-47.




2020     |     www.medigraphic.com