Benefits of adjuvant radiotherapy after radical resection of locally advanced main hepatic duct carcinoma

Todoroki, Takeshi; Ohara, Kiyoshi; Kawamoto, Toru; Koike, Naoto; Yoshida, Sadao; Kashiwagi, Hironobu; Otsuka, Masaaki; Fukao, Katashi

doi:10.1016/s0360-3016(99)00472-1

Cited by 179 publications

(130 citation statements)

References 28 publications

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“…Cheng et al [192] 2007 Hilar cholangiocarcinoma HR 4.3, 95% CI 3.6-4.9 < 0.01 Radiation was significantly helpful for R1/2 resection patients Todoroki et al [191] 2000 Bile duct cancer 14% 5-yr OS 34% 5-yr OS 0.010 Radiation was significantly helpful for R1 resection patients Gerhards et al [197] 2003 Hilar cholangiocarcinoma 8 mo MS 24 mo MS < 0.05 Chemoradiation Without chemoradiation With chemoradiation Nakeeb et al [198] 2002 Bile duct cancer 11 mo MS (Chemotherapy alone)…”

Section: Nsmentioning

confidence: 98%

“…In contrast, several large retrospective series suggested a survival benefit with adjuvant radiation. Todoroki et al [191] demonstrated a significantly higher 5-year survival of 34% in patients with R1 resections with adjuvant radiotherapy (intraoperative and extra beam) compared to 14% with surgery alone. Similarly, Cheng et al [192] and Schoenthaler et al [193] reported the efficacy of adjuvant radiation for the survival of patients with R1 or R2 resections.…”

Section: Adjuvant Radiotherapymentioning

confidence: 99%

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Surgical strategy for bile duct cancer: Advances and current limitations

Akamatsu

Sugawara²,

Hashimoto³

2011

WJCO

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The aim of this review is to describe recent advances and topics in the surgical management of bile duct cancer. Radical resection with a microscopically negative margin (R0) is the only way to cure cholangiocarcinoma and is associated with marked survival advantages compared to margin-positive resections. Complete resection of the tumor is the surgeon's ultimate aim, and several advances in the surgical treatment for bile duct cancer have been made within the last two decades. Multidetector row computed tomography has emerged as an indispensable diagnostic modality for the precise preoperative evaluation of bile duct cancer, in terms of both longitudinal and vertical tumor invasion. Many meticulous operative procedures have been established, especially extended hepatectomy for hilar cholangiocarcinoma, to achieve a negative resection margin, which is the only prognostic factor under the control of the surgeon. A complete caudate lobectomy and resection of the inferior part of Couinaud's segment Ⅳ coupled with right or left hemihepatectomy has become the standard surgical procedure for hilar cholangiocarcinoma, and pyloruspreserving pancreaticoduodenectomy is the first choice for distal bile duct cancer. Limited resection for middle bile duct cancer is indicated for only strictly selected cases. Preoperative treatments including biliary drainage and portal vein embolization are also indicated for only selected patients, especially jaundiced patients anticipating major hepatectomy. Liver transplantation seems ideal for complete resection of bile duct cancer, but the high recurrence rate and decreased patient survival after liver transplant preclude it from being considered standard treatment. Adjuvant chemotherapy and radiotherapy have a potentially crucial role in prolonging survival and controlling local recurrence, but no definite regimen has been established to date. Further evidence is needed to fully define the role of liver transplantation and adjuvant chemo-radiotherapy.

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Section: Nsmentioning

confidence: 98%

Section: Adjuvant Radiotherapymentioning

confidence: 99%

Surgical strategy for bile duct cancer: Advances and current limitations

Akamatsu

Sugawara²,

Hashimoto³

2011

WJCO

View full text Add to dashboard Cite

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“…Patients receiving radiation had a substantial improvement in median survival (24 vs 8 months, P o 0.01). In another study by Todoroki et al, 33 29 patients were treated with a combination of postoperative IORT and EBRT, IORT alone, or EBRT alone. Compared with 20 patients not receiving adjuvant radiation, postoperative radiation resulted in significantly improved median survival (32 vs 20 months, P ¼ 0.01).…”

Section: Adjuvant Rtmentioning

confidence: 99%

WITHDRAWN: Defining the Role of Adjuvant Therapy: Cholangiocarcinoma and Gallbladder Cancer

Williams

Majithia

Wang

et al. 2014

Seminars in Arthroplasty

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“…10,18,19 Because of the rarity of the disease, however, no prospective randomized controlled trials comparing adjuvant RT with observation have been performed, and retrospective studies have yielded conflicting results with insufficient evidences supporting the survival benefit of adjuvant RT. 18,[20][21][22] In this study, we retrospectively analyzed the effect of adjuvant RT on local relapse-free survival and OS for patients with EHBD cancer treated with surgical resection with or without adjuvant RT.…”

Section: Introductionmentioning

confidence: 99%

Role of adjuvant radiotherapy for localized extrahepatic bile duct cancer

Kim

Min

et al. 2017

The British Journal of Radiology

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Objective: To evaluate the benefit of adjuvant radiotherapy (RT) after surgical resection for extrahepatic bile duct (EHBD) cancer. Methods: From 1997 to 2015, 59 patients with EHBD cancer were the subject of this study; 36 patients not undergoing adjuvant treatment after surgery (observation group) and 23 patients receiving adjuvant RT (RT group) were compared. Microscopic residual disease (R1) was in 9 (25%) patients and 5 (22%) patients, and macroscopic residual disease (R2) was in 2 (6%) patients and 6 (26%) patients in the observation and RT groups, respectively. Adjuvant RT was delivered to the tumour bed and regional lymph nodes up to 50.4 Gy (range, 45-61 Gy). Results: With a median follow-up of 19 months, local recurrence was observed in 10 (28%) patients and 2 (9%) patients in the observation and RT groups, respectively. On univariate analysis, the 5-year local recurrence-free survival (LRFS) rates were 50% in the observation group and 54% in the RT group (p 5 0.401).The 5-year overall survival (OS) rates were 29.3% in the observation group and 26.3% in the RT group (p 5 0.602). On multivariable analysis, however, adjuvant RT significantly improved LRFS [hazard ratio (HR), 0.310; 95% confidence interval (CI), 0.100-0.963; p 5 0.043] and had a trend towards increased OS (HR, 0.491; 95% CI, 0.219-1.102; p 5 0.085). Resection margin (RM) status was also correlated with LRFS (HR for R1 6.134, 95% CI 2. and HR for R2 18.551,; p , 0.001) and OS (HR for R1 1.816, 95% CI 0.853-3.867; and HR for R2 3.564, 95% CI 1.175-10.809; p 5 0.054). Conclusion: RM status was a significant prognosticator of EHBD cancer, and adjuvant RT improved local control rate; thereby, survival rate might be increased. Advances in knowledge: The benefit of adjuvant RT in EHBD cancer was demonstrated via comparison with observation group.

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Benefits of adjuvant radiotherapy after radical resection of locally advanced main hepatic duct carcinoma

Cited by 179 publications

References 28 publications

Surgical strategy for bile duct cancer: Advances and current limitations

Surgical strategy for bile duct cancer: Advances and current limitations

WITHDRAWN: Defining the Role of Adjuvant Therapy: Cholangiocarcinoma and Gallbladder Cancer

Role of adjuvant radiotherapy for localized extrahepatic bile duct cancer

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