Time to surgery is not an oncological risk factor in patients with cholangiocarcinoma undergoing curative-intent liver surgery.

Journal

Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288

Informations de publication

Date de publication:
18 Jan 2024
Historique:
received: 20 03 2023
accepted: 27 12 2023
medline: 19 1 2024
pubmed: 19 1 2024
entrez: 18 1 2024
Statut: epublish

Résumé

Surgical resection is the only option to achieve long-term survival in cholangiocellular carcinoma (CCA). Due to limitations of health care systems and unforeseeable events, e.g., the COVID pandemic, the time from diagnosis to surgery (time-to-surgery (TTS)) has gained great interest in malignancies. Thus, we investigated whether TTS is associated with the oncological outcome in patients who underwent surgery for CCA. A cohort of 276 patients undergoing curative-intent surgery for intrahepatic and perihilar CCA excluding individuals with neoadjuvant therapy and perioperative mortality between 2010 and 2021 were eligible for analysis. Patients were grouped according to TTS (≤ 30; 31-60; 61-90; > 90 days) and compared by Kruskal-Wallis-analysis. Survival was compared using Kaplan-Meier analysis and characteristics associated with cancer-specific survival (CSS), recurrence-free survival (RFS) and overall survival (OS) using Cox regressions. The median CSS was 39 months (3-year-CSS = 52%, 5-year-CSS = 42%) and the median RFS 20 months (3-year-CSS = 38%, 5-year-CSS = 33%). In univariable Cox regressions, TTS was not associated with CSS (p = 0.971) or RFS (p = 0.855), respectively. A grouped analysis with respect to TTS (≤ 30 days, n = 106; 31-60 days, n = 134; 61-90 days, n = 44; > 90 days, n = 29) displayed a median CSS of 38, 33, 51 and 41 months and median RFS of 17, 22, 28 and 20 months (p = 0.971 log rank; p = 0.520 log rank). No statistical difference regarding oncological risk factors were observed between the groups. This study is the first comprehensive analysis of TTS in CCA patients. Within a representative European cohort, TTS was not associated with earlier tumor recurrence or reduced CCS.

Identifiants

DOI: 10.1038/s41598-023-50842-6 PMID: 38238432
pubmed: 38238432
doi: 10.1038/s41598-023-50842-6
pii: 10.1038/s41598-023-50842-6
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1644

Subventions

Organisme : Chinese Government Scholarship
ID : 202208080011

Informations de copyright

© 2024. The Author(s).

Références

Tischoff, I. & Tannapfel, A. Hepatocellular carcinoma and cholangiocarcinoma–different prognosis, pathogenesis and therapy. Zentralbl Chir. 132(4), 300–305. https://doi.org/10.1055/s-2007-981195 (2007).
doi: 10.1055/s-2007-981195 pubmed: 17724632
Banales, J. M. et al. Cholangiocarcinoma 2020: The next horizon in mechanisms and management. Nat. Rev. Gastroenterol. Hepatol. 17(9), 557–588. https://doi.org/10.1038/s41575-020-0310-z (2020).
doi: 10.1038/s41575-020-0310-z pubmed: 32606456 pmcid: 7447603
Patel, T. Cholangiocarcinoma–controversies and challenges. Nat. Rev. Gastroenterol. Hepatol. 8(4), 189–200. https://doi.org/10.1038/nrgastro.2011.20 (2011).
doi: 10.1038/nrgastro.2011.20 pubmed: 21460876 pmcid: 3888819
Bertuccio, P. et al. Global trends in mortality from intrahepatic and extrahepatic cholangiocarcinoma. J. Hepatol. 71(1), 104–114. https://doi.org/10.1016/j.jhep.2019.03.013 (2019).
doi: 10.1016/j.jhep.2019.03.013 pubmed: 30910538
Lamarca, A., Edeline, J. & Goyal, L. How I treat biliary tract cancer. ESMO Open 7(1), 100378. https://doi.org/10.1016/j.esmoop.2021.100378 (2022).
doi: 10.1016/j.esmoop.2021.100378 pubmed: 35032765 pmcid: 8762076
Bednarsch, J. et al. Bacterial bile duct colonization in perihilar cholangiocarcinoma and its clinical significance. Sci. Rep. 11(1), 2926. https://doi.org/10.1038/s41598-021-82378-y (2021).
doi: 10.1038/s41598-021-82378-y pubmed: 33536484 pmcid: 7858613
Mueller, M. et al. Perihilar cholangiocarcinoma—novel benchmark values for surgical and oncological outcomes from 24 expert centers. Ann. Surg. 274(5), 780–788. https://doi.org/10.1097/SLA.0000000000005103 (2021).
doi: 10.1097/SLA.0000000000005103 pubmed: 34334638
Bednarsch, J. et al. Leakage and stenosis of the hepaticojejunostomy following surgery for perihilar cholangiocarcinoma. J. Clin. Med. https://doi.org/10.3390/jcm9051392 (2020).
doi: 10.3390/jcm9051392 pubmed: 32397289 pmcid: 7290596
Arndt, V. et al. Cancer care in German centers of excellence during the first 2 years of the COVID-19 pandemic. J. Cancer Res. Clin. Oncol. https://doi.org/10.1007/s00432-022-04407-1 (2022).
doi: 10.1007/s00432-022-04407-1 pubmed: 36495330 pmcid: 9889481
Hanna, T. P. et al. Mortality due to cancer treatment delay: Systematic review and meta-analysis. Bmj 371, m4087. https://doi.org/10.1136/bmj.m4087 (2020).
doi: 10.1136/bmj.m4087 pubmed: 33148535
Bednarsch, J. et al. The prognostic role of in-hospital transfusion of fresh frozen plasma in patients with cholangiocarcinoma undergoing curative-intent liver surgery. Eur. J. Surg. Oncol. https://doi.org/10.1016/j.ejso.2021.09.011 (2021).
doi: 10.1016/j.ejso.2021.09.011 pubmed: 34565633
Bednarsch, J. et al. The prognostic role of tumor-associated unilateral portal vein occlusion in perihilar cholangiocarcinoma. HPB https://doi.org/10.1016/j.hpb.2021.03.012 (2021).
doi: 10.1016/j.hpb.2021.03.012 pubmed: 35078714
Primrose, J. N. et al. Capecitabine compared with observation in resected biliary tract cancer (BILCAP): A randomised, controlled, multicentre, phase 3 study. Lancet Oncol. 20(5), 663–673. https://doi.org/10.1016/S1470-2045(18)30915-X (2019).
doi: 10.1016/S1470-2045(18)30915-X pubmed: 30922733
Ikemura, M. et al. Impact of the coronavirus disease-2019 pandemic on pancreaticobiliary disease detection and treatment. J. Clin. Med. https://doi.org/10.3390/jcm10184177 (2021).
doi: 10.3390/jcm10184177 pubmed: 34575288 pmcid: 8470255
Ruys, A. T. et al. Delay in surgical treatment of patients with hilar cholangiocarcinoma: Does time impact outcomes?. HPB (Oxford). 16(5), 469–474. https://doi.org/10.1111/hpb.12156 (2014).
doi: 10.1111/hpb.12156 pubmed: 24033549
Gamboa, A. C. et al. Optimal timing and treatment strategy for pancreatic cancer. J. Surg. Oncol. 122(3), 457–468. https://doi.org/10.1002/jso.25976 (2020).
doi: 10.1002/jso.25976 pubmed: 32470166 pmcid: 7396281
Okuno, K. et al. Impact of preoperative time interval on survival in patients with gastric cancer. World J. Surg. 45(9), 2860–2867. https://doi.org/10.1007/s00268-021-06187-0 (2021).
doi: 10.1007/s00268-021-06187-0 pubmed: 34121136
Chen, E. Y. et al. Effect of time to surgery of colorectal liver metastases on survival. J. Gastrointest. Cancer 52(1), 169–176. https://doi.org/10.1007/s12029-020-00372-5 (2021).
doi: 10.1007/s12029-020-00372-5 pubmed: 32086781
Bennett, S. et al. Strategies for the delay of surgery in the management of resectable hepatobiliary malignancies during the COVID-19 pandemic. Curr. Oncol. 27(5), e501–e511. https://doi.org/10.3747/co.27.6785 (2020).
doi: 10.3747/co.27.6785 pubmed: 33173390 pmcid: 7606047
Bednarsch, J. et al. Compelling long-term results for liver resection in early cholangiocarcinoma. J. Clin. Med. https://doi.org/10.3390/jcm10132959 (2021).
doi: 10.3390/jcm10132959 pubmed: 34300246 pmcid: 8306993
Mizuno, T. et al. Combined vascular resection for locally advanced perihilar cholangiocarcinoma. Ann. Surg. 275(2), 382–390. https://doi.org/10.1097/SLA.0000000000004322 (2022).
doi: 10.1097/SLA.0000000000004322 pubmed: 32976284
Yoh, T. et al. Is Surgical resection justified for advanced intrahepatic cholangiocarcinoma?. Liver Cancer 5(4), 280–289. https://doi.org/10.1159/000449339 (2016).
doi: 10.1159/000449339 pubmed: 27781200 pmcid: 5075804
Sahara, K. et al. Defining the risk of early recurrence following curative-intent resection for distal cholangiocarcinoma. Ann. Surg. Oncol. 28(8), 4205–4213. https://doi.org/10.1245/s10434-021-09811-4 (2021).
doi: 10.1245/s10434-021-09811-4 pubmed: 33709171
Lurje, G. et al. The prognostic role of lymphovascular invasion and lymph node metastasis in perihilar and intrahepatic cholangiocarcinoma. Eur. J. Surg. Oncol. 45(8), 1468–1478. https://doi.org/10.1016/j.ejso.2019.04.019 (2019).
doi: 10.1016/j.ejso.2019.04.019 pubmed: 31053477
Tran, T. B. et al. Actual 5-year survivors after surgical resection of hilar cholangiocarcinoma. Ann. Surg. Oncol. 26(2), 611–618. https://doi.org/10.1245/s10434-018-7075-4 (2019).
doi: 10.1245/s10434-018-7075-4 pubmed: 30539494
Lopez-Aguiar, A. G. et al. Association of perioperative transfusion with recurrence and survival after resection of distal cholangiocarcinoma: A 10-institution study from the US extrahepatic biliary malignancy consortium. Ann. Surg. Oncol. 26(6), 1814–1823. https://doi.org/10.1245/s10434-019-07306-x (2019).
doi: 10.1245/s10434-019-07306-x pubmed: 30877497 pmcid: 10182408
Tamoto, E. et al. Portal vein resection using the no-touch technique with a hepatectomy for hilar cholangiocarcinoma. HPB 16(1), 56–61. https://doi.org/10.1111/hpb.12067 (2014).
doi: 10.1111/hpb.12067 pubmed: 23461754
Bednarsch, J. et al. The prognostic role of tumor-associated unilateral portal vein occlusion in perihilar cholangiocarcinoma. HPB 23(10), 1565–1577. https://doi.org/10.1016/j.hpb.2021.03.012 (2021).
doi: 10.1016/j.hpb.2021.03.012 pubmed: 33934958
Waterland, J. L. et al. Efficacy of prehabilitation including exercise on postoperative outcomes following abdominal cancer surgery: A systematic review and meta-analysis. Front. Surg. 8, 628848. https://doi.org/10.3389/fsurg.2021.628848 (2021).
doi: 10.3389/fsurg.2021.628848 pubmed: 33816546 pmcid: 8017317
Jain, S. R. et al. The role and effect of multimodal prehabilitation before major abdominal surgery: A systemic review and meta-analysis. World J. Surg. https://doi.org/10.1007/s00268-022-06761-0 (2022).
doi: 10.1007/s00268-022-06761-0 pubmed: 36184673 pmcid: 9436886
Ribero, D. et al. Preoperative cholangitis and future liver remnant volume determine the risk of liver failure in patients undergoing resection for hilar cholangiocarcinoma. J. Am. Coll. Surg. https://doi.org/10.1016/j.jamcollsurg.2016.01.060 (2016).
doi: 10.1016/j.jamcollsurg.2016.01.060 pubmed: 27049784 pmcid: 4925184
Coelen, R. J. S. et al. Endoscopic versus percutaneous biliary drainage in patients with resectable perihilar cholangiocarcinoma: A multicentre, randomised controlled trial. Lancet Gastroenterol. Hepatol. 3(10), 681–690. https://doi.org/10.1016/S2468-1253(18)30234-6 (2018).
doi: 10.1016/S2468-1253(18)30234-6 pubmed: 30122355

Auteurs

Anna Mantas (A)

Department of Surgery and Transplantation, University Hospital RWTH Aachen, Aachen, Germany.
Department of Surgery and Transplantation, University Hospital Essen, Essen, Germany.

Dong Liu (D)

Department of Surgery and Transplantation, University Hospital RWTH Aachen, Aachen, Germany.

Carlos Constantin Otto (CC)

Department of Surgery and Transplantation, University Hospital RWTH Aachen, Aachen, Germany.
Department of Surgery and Transplantation, University Hospital Essen, Essen, Germany.

Lara Rosaline Heij (LR)

Department of Surgery and Transplantation, University Hospital RWTH Aachen, Aachen, Germany.
Department of Surgery and Transplantation, University Hospital Essen, Essen, Germany.
Institute of Pathology, University Hospital RWTH Aachen, Aachen, Germany.

Daniel Heise (D)

Department of Surgery and Transplantation, University Hospital RWTH Aachen, Aachen, Germany.
Department of Surgery and Transplantation, University Hospital Essen, Essen, Germany.

Philipp Bruners (P)

Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Aachen, Germany.

Sven Arke Lang (SA)

Department of Surgery and Transplantation, University Hospital RWTH Aachen, Aachen, Germany.
Department of Surgery and Transplantation, University Hospital Essen, Essen, Germany.

Tom Florian Ulmer (TF)

Department of Surgery and Transplantation, University Hospital RWTH Aachen, Aachen, Germany.
Department of Surgery and Transplantation, University Hospital Essen, Essen, Germany.

Ulf Peter Neumann (UP)

Department of Surgery and Transplantation, University Hospital RWTH Aachen, Aachen, Germany.
Department of Surgery and Transplantation, University Hospital Essen, Essen, Germany.
Department of Surgery, Maastricht University Medical Center (MUMC), Maastricht, The Netherlands.

Jan Bednarsch (J)

Department of Surgery and Transplantation, University Hospital RWTH Aachen, Aachen, Germany. jan.bednarsch@uk-essen.de.
Department of Surgery and Transplantation, University Hospital Essen, Essen, Germany. jan.bednarsch@uk-essen.de.

Classifications MeSH