USF-LVHN SELECT
Anatomic patterns of recurrence in biliary tract cancers: does primary tumor site matter?
Publication/Presentation Date
6-1-2022
Abstract
BACKGROUND: Recommendations for postoperative surveillance and adjuvant therapy following curative-intent resection for biliary tract cancers-including intrahepatic and extrahepatic cholangiocarcinoma (IHCCA and EHCCA) and primary gallbladder cancer (GBC)-are uniform across primary tumor site. However, these tumors may have distinct patterns of recurrence.
METHODS: A retrospective observational cohort study was performed at a specialty cancer center. Patients undergoing resection of IHCCA, EHCCA, and GBC were identified (2005-2020). Recurrence-free survival (RFS) was estimated using Kaplan-Meier and Cox proportional hazard methods. Anatomic patterns of initial site of recurrence were described and compared.
RESULTS: There were 142 patients included; 50 IHCCA, 32 EHCCA, and 60 GBC. Median RFS was 30.8 months, which was not significantly different between IHCCA, EHCCA, or GBC in univariate analysis or after adjustment. Nodal positivity was significantly associated with poor RFS (HR 3.92, P≤0.001). The most common initial site of recurrence overall was intrahepatic (n=49/64, 77%), in isolation (n=32) or synchronous with other site of recurrence (n=17). Significant differences in anatomic pattern of recurrence were observed (P=0.049) with IHCCAs more commonly recurring with simultaneous hepatic-pulmonary disease (n=5/22, 23%; EHCCA n=2/19, 10%; GBC n=1/23, 4%), GBC more commonly recurring within the porta (n=7/23, 30%; IHCCA n=0; EHCCA n=1/19, 5%), and EHCCA more commonly recurring within the peritoneum (n=5/19, 26%; IHCCA n=2/22, 9%, GBC n=2/23, 9%).
CONCLUSIONS: Patterns of initial recurrence appear to differ between primary tumor site, likely reflecting underlying differences in anatomy and biology. These data could help inform future studies for adjuvant therapy as well as timing and anatomic focus for surveillance imaging.
Volume
13
Issue
3
First Page
1413
Last Page
1422
ISSN
2078-6891
Published In/Presented At
Sinnamon, A. J., Wood, A. C., Satyadi, M. A., Levitt, C. V., Hardy, O., Haider, M., Kim, R. D., Anaya, D. A., & Denbo, J. W. (2022). Anatomic patterns of recurrence in biliary tract cancers: does primary tumor site matter?. Journal of gastrointestinal oncology, 13(3), 1413–1422. https://doi.org/10.21037/jgo-21-868
Disciplines
Medical Education | Medicine and Health Sciences
PubMedID
35837169
Department(s)
USF-LVHN SELECT Program, USF-LVHN SELECT Program Students
Document Type
Article