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Occurrence of seeding metastases in resectable perihilar cholangiocarcinoma and the role of low-dose radiotherapy to prevent this

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World Journal of Hepatology 2020年第11期12卷 1089-1097页

作者： Lotte C Franken Eva Roos Job Saris Jeanin E van Hooft Otto M van Delden Joanne Verheij Joris I Erdmann Marc G Besselink Olivier R Busch Geertjan van Tienhoven Thomas M van Gulik Department of Surgery Cancer Center AmsterdamAmsterdam UMCUniversity of AmsterdamAmsterdam 1105 AZNetherlands Department of Pathology Amsterdam UMCUniversity of AmsterdamAmsterdam 1105 AZNetherlands Department of Gastroenterology Amsterdam UMCUniversity of AmsterdamAmsterdam 1105 AZNetherlands Department of Interventional Radiology Amsterdam UMCUniversity of AmsterdamAmsterdam 1105 AZNetherlands Department of Radiation Oncology Amsterdam UMCUniversity of AmsterdamAmsterdam 1105 AZNetherlands

BACKGROUND Preoperative biliary drainage in patients with presumed resectable perihilar cholangiocarcinoma(PHC)is hypothesized to promote the occurrence of seeding *** metastases can occur at the surgical scars or at the site of postoperative drains,and in case of percutaneous biliary drainage,at the catheter *** prevent seeding metastases after resection,we routinely treated PHC patients with preoperative radiotherapy(RT)for over 25 years until January *** To investigate the incidence of seeding metastases following resection of *** All patients who underwent resection for pathology proven PHC between January 2000 and March 2019 were included in this retrospective *** 2000-January 2018,patients received preoperative RT(3×3.5 Gray).RT was omitted in patients treated after January *** A total of 171 patients underwent resection for PHC between January 2000 and March *** 171 patients undergoing resection,111 patients(65%)were treated with preoperative *** bile cytology showed no difference in the presence of viable tumor cells in bile of patients undergoing preoperative RT or ***,two patients(1.2%)with seeding metastases were identified,both in the laparotomy scar and both after preoperative RT(one patient with endoscopic and the other with percutaneous and endoscopic biliary drainage).CONCLUSION The incidence of seeding metastases in patients with resected PHC in our series was low(1.2%).This low incidence and the inability of providing evidence that preoperative low-dose RT prevents seeding metastases,has led us to discontinue preoperative RT in patients with resectable PHC in our center.

关键词： Perihilar cholangiocarcinoma Seeding metastases preventive radiotherapy

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