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논문 기본 정보

자료유형
학술저널
저자정보
Koo, Tae Ryool (Department of Radiation Oncology, Seoul National University College of Medicine) Eom, Keun-Yong (Department of Radiation Oncology, Seoul National University College of Medicine) Kim, In Ah (Department of Radiation Oncology, Seoul National University College of Medicine) Cho, Jai Young (Department of Surgery, Seoul National University College of Medicine) Yoon, Yoo-Seok (Department of Surgery, Seoul National University College of Medicine) Hwang, Dae Wook (Department of Surgery, Seoul National University College of Medicine) Han, Ho-Seong (Department of Surgery, Seoul National University College of Medicine) Kim, Jae-Sung (Department of Radiation Oncology, Seoul National University College of Medicine)
저널정보
대한방사선종양학회 Radiation oncology journal : ROJ Radiation oncology journal : ROJ 제32권 제2호
발행연도
2014.1
수록면
63 - 69 (7page)

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Purpose: To find the applicability of adjuvant radiotherapy for extrahepatic bile duct cancer (EBDC), we analyzed the pattern of failure and evaluate prognostic factors of locoregional failure after curative resection without adjuvant treatment. Materials and Methods: In 97 patients with resected EBDC, the location of tumor was classified as proximal (n = 26) and distal (n = 71), using the junction of the cystic duct and common hepatic duct as the dividing point. Locoregional failure sites were categorized as follows: the hepatoduodenal ligament and tumor bed, the celiac artery and superior mesenteric artery, and other sites. Results: The median follow-up time was 29 months for surviving patients. Three-year locoregional progression-free survival, progression-free survival, and overall survival rates were 50%, 42%, and 52%, respectively. Regarding initial failures, 79% and 81% were locoregional failures in proximal and distal EBDC patients, respectively. The most common site was the hepatoduodenal ligament and tumor bed. In the multivariate analysis, perineural invasion was associated with poor locoregional progression-free survival (p = 0.023) and progression-free survival (p = 0.012); and elevated postoperative CA19-9 (${\geq}37U/mL$) did with poor locoregional progression-free survival (p = 0.002), progression-free survival (p < 0.001) and overall survival (p < 0.001). Conclusion: Both proximal and distal EBDC showed remarkable proportion of locoregional failure. Perineural invasion and elevated postoperative CA19-9 were risk factors of locoregional failure. In these patients with high risk of locoregional failure, adjuvant radiotherapy could be considered to improve locoregional control.

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