Patterns of Initial Disease Recurrence after Resection of Biliary Tract Cancer

Authors:
  • SWSang Myung Woo
    Sang Myung Woo
  • HPHyung Ki Park
    Hyung Ki Park
  • WLWoo Jin Lee
    Woo Jin Lee
  • MHMi Ah Han
    Mi Ah Han
  • SHSung-Sik Han
    Sung-Sik Han
  • SKSeong Hoon Kim
    Seong Hoon Kim
  • SPSang-Jae Park
    Sang-Jae Park
  • YKYoung Hwan Koh
    Young Hwan Koh
  • EHEun Kyung Hong
    Eun Kyung Hong
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Abstract
Objectives: This study aimed to provide further insights into the indications for adjuvant therapeutic strategies via analysis of the sites of initial recurrence after resection of gallbladder cancer (GBC) and intrahepatic (IHC) and extrahepatic cholangiocarcinoma (EHC). Methods: Patients with biliary tract cancer who underwent potentially curative resection were identified from the database. Sites of initial disease recurrence were categorized as locoregional or distant. Results: Between March 2001 and April 2009, 231 patients underwent curative resection. Initial GBC and IHC recurrence involving a distant site occurred in 70.8 and 86.8% patients, respectively, compared to 56.9% patients with EHC (p = 0.002). The median time to disease recurrence (TTR) was shorter among the GBC and IHC groups compared with that in EHC patients (6.3 and 6.7 vs. 13.1 months, respectively; p = 0.003). Moreover, median times to distant recurrence in GBC and IHC groups were shorter than that in EHC (5.8 and 6.5 vs. 14.1 months, respectively; p = 0.002). Conclusions: After resection, recurrent GBC and IHC are more likely to involve a distant site and are associated with significantly shorter TTR than recurrent EHC. These findings suggest that an adjuvant therapeutic strategy targeting distant disease is likely to have a significant impact on the overall management of GBC and IHC.

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