肝门部胆管癌手术切缘的研究进展

王艺睿; 刘硕琛; 李相成

doi:10.3969/j.issn.1001-5256.2021.11.056

肝门部胆管癌手术切缘的研究进展

DOI: 10.3969/j.issn.1001-5256.2021.11.056

南京医科大学第一附属医院肝胆中心，南京 210029

基金项目:

江苏省重点病种规范化诊疗研究项目 (BE2016789);

国家自然科学基金 (81670570)

详细信息

通信作者:
李相成，drxcli@njmu.edu.cn

中图分类号: R735.8
计量
- 文章访问数: 832
- HTML全文浏览量: 571
- PDF下载量: 56
- 被引次数: 0
出版历程
- 收稿日期: 2021-04-01
- 录用日期: 2021-04-16
- 出版日期: 2021-11-20

Research advances in surgical margin of hilar cholangiocarcinoma

Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China

Research funding:

Project of Standardized Diagnosis and Treatment of Key Diseases in Jiangsu Province (BE2016789);

National Natural Science Foundation of China (81670570)

摘要

摘要: 肝门部胆管癌是最常见的胆道肿瘤，外科手术仍是目前唯一可能有效的治疗方法。手术切缘的性质是患者长期预后的重要影响因素，根治性切除可使患者获得极大的生存获益。肝门部胆管癌环周切缘的评估，有助于更精准地判断切缘性质和预测患者预后。现对肝门部胆管癌的手术切缘最新研究进展进行综述。
- Klatskin肿瘤 /
- 切缘 /
- 预后
Abstract: Hilar cholangiocarcinoma (HCCA) is the most common biliary malignancy, and surgical operation is the only possible treatment method at present. The nature of surgical margin is an important influencing factor for the long-term survival of patients, and radical resection can bring great survival benefits to patients. The determination of radial margin for HCCA can help to evaluate the nature of surgical margin and predict the prognosis of patients more accurately. This article reviews the latest research advances in the surgical margin of HCCA.
- Klatskin Tumor /
- Margins of Excision /
- Prognosis

HTML全文

参考文献(32)

[1]	RIZVI S, KHAN SA, HALLEMEIER CL, et al. Cholangiocarcinoma-evolving concepts and therapeutic strategies[J]. Nat Rev Clin Oncol, 2018, 15(2): 95-111. DOI: 10.1038/nrclinonc.2017.157.
[2]	SAHA SK, ZHU AX, FUCHS CS, et al. Forty-year trends in cholangiocarcinoma incidence in the U.S. : Intrahepatic disease on the rise[J]. Oncologist, 2016, 21(5): 594-599. DOI: 10.1634/theoncologist.2015-0446.
[3]	BANALES JM, MARIN J, LAMARCA A, et al. Cholangiocarcinoma 2020: The next horizon in mechanisms and management[J]. Nat Rev Gastroenterol Hepatol, 2020, 17(9): 557-588. DOI: 10.1038/s41575-020-0310-z.
[4]	KHAN AS, DAGEFORDE LA. Cholangiocarcinoma[J]. Surg Clin North Am, 2019, 99(2): 315-335. DOI: 10.1016/j.suc.2018.12.004.
[5]	LI XC, FENG QC. Advance and controversy of hilar cholangiocarcinoma[J]. J Clin Hepatol, 2019, 35(12): 2632-2637. DOI: 10.3969/j.issn.1001-5256.2019.12.004. 李相成, 冯勤超. 肝门部胆管癌的进展与争议[J]. 临床肝胆病杂志, 2019, 35(12): 2632-2637. DOI: 10.3969/j.issn.1001-5256.2019.12.004.
[6]	FORNER A, VIDILI G, RENGO M, et al. Clinical presentation, diagnosis and staging of cholangiocarcinoma[J]. Liver Int, 2019, 39(Suppl 1): 98-107. DOI: 10.1111/liv.14086.
[7]	SAKAMOTO Y, KOSUGE T, SHIMADA K, et al. Prognostic factors of surgical resection in middle and distal bile duct cancer: An analysis of 55 patients concerning the significance of ductal and radial margins[J]. Surgery, 2005, 137(4): 396-402. DOI: 10.1016/j.surg.2004.10.008.
[8]	MANTEL HT, WESTERKAMP AC, SIEDERS E, et al. Intraoperative frozen section analysis of the proximal bile ducts in hilar cholangiocarcinoma is of limited value[J]. Cancer Med, 2016, 5(7): 1373-1380. DOI: 10.1002/cam4.693.
[9]	SHINOHARA K, EBATA T, SHIMOYAMA Y, et al. A study on radial margin status in resected perihilar cholangiocarcinoma[J]. Ann Surg, 2021, 273(3): 572-578. DOI: 10.1097/SLA.0000000000003305.
[10]	STREMITZER S, STIFT J, LAENGLE J, et al. Prognosis and circumferential margin in patients with resected hilar cholangiocarcinoma[J]. Ann Surg Oncol, 2021, 28(3): 1493-1498. DOI: 10.1245/s10434-020-09105-1.
[11]	AHMAD J, LOUGHREY MB, DONNELLY D, et al. Prognostic value of added stratification of circumferential resection margin status in oesophageal carcinoma[J]. Histopathology, 2013, 62(5): 752-763. DOI: 10.1111/his.12078.
[12]	BUETTNER S, MARGONIS GA, KIM Y, et al. Conditional probability of long-term survival after resection of hilar cholangiocarcinoma[J]. HPB (Oxford), 2016, 18(6): 510-517. DOI: 10.1016/j.hpb.2016.04.001.
[13]	RIBERO D, PINNA AD, GUGLIELMI A, et al. Surgical approach for long-term survival of patients with intrahepatic cholangiocarcinoma: A multi-institutional analysis of 434 patients[J]. Arch Surg, 2012, 147(12): 1107-1113. DOI: 10.1001/archsurg.2012.1962.
[14]	de JONG MC, MARQUES H, CLARY BM, et al. The impact of portal vein resection on outcomes for hilar cholangiocarcinoma: A multi-institutional analysis of 305 cases[J]. Cancer, 2012, 118(19): 4737-4747. DOI: 10.1002/cncr.27492.
[15]	SHINGU Y, EBATA T, NISHIO H, et al. Clinical value of additional resection of a margin-positive proximal bile duct in hilar cholangiocarcinoma[J]. Surgery, 2010, 147(1): 49-56. DOI: 10.1016/j.surg.2009.06.030.
[16]	LI CX, ZHANG H, WANG K, et al. Preoperative bilirubin level predicts overall survival and tumor recurrence after resection for perihilar cholangiocarcinoma patients[J]. Cancer Manag Res, 2019, 11: 10157-10165. DOI: 10.2147/CMAR.S230620.
[17]	KOMAYA K, EBATA T, YOKOYAMA Y, et al. Recurrence after curative-intent resection of perihilar cholangiocarcinoma: Analysis of a large cohort with a close postoperative follow-up approach[J]. Surgery, 2018, 163(4): 732-738. DOI: 10.1016/j.surg.2017.08.011.
[18]	ZHANG XF, SQUIRES MH 3rd, BAGANTE F, et al. The impact of intraoperative re-resection of a positive bile duct margin on clinical outcomes for hilar cholangiocarcinoma[J]. Ann Surg Oncol, 2018, 25(5): 1140-1149. DOI: 10.1245/s10434-018-6382-0.
[19]	OGURO S, ESAKI M, KISHI Y, et al. Optimal indications for additional resection of the invasive cancer-positive proximal bile duct margin in cases of advanced perihilar cholangiocarcinoma[J]. Ann Surg Oncol, 2015, 22(6): 1915-1924. DOI: 10.1245/s10434-014-4232-2.
[20]	GOVIL S, REDDY MS, RELA M. Surgical resection techniques for locally advanced hilar cholangiocarcinoma[J]. Langenbecks Arch Surg, 2014, 399(6): 707-716. DOI: 10.1007/s00423-014-1216-4.
[21]	PORUK KE, PAWLIK TM, WEISS MJ. Perioperative management of hilar cholangiocarcinoma[J]. J Gastrointest Surg, 2015, 19(10): 1889-1899. DOI: 10.1007/s11605-015-2854-8.
[22]	SOARES KC, KAMEL I, COSGROVE DP, et al. Hilar cholangiocarcinoma: Diagnosis, treatment options, and management[J]. Hepatobiliary Surg Nutr, 2014, 3(1): 18-34. DOI: 10.3978/j.issn.2304-3881.2014.02.05.
[23]	WEISS MJ, COSGROVE D, HERMAN JM, et al. Multimodal treatment strategies for advanced hilar cholangiocarcinoma[J]. Langenbecks Arch Surg, 2014, 399(6): 679-692. DOI: 10.1007/s00423-014-1219-1.
[24]	CHATELAIN D, FARGES O, FUKS D, et al. Assessment of pathology reports on hilar cholangiocarcinoma: The results of a nationwide, multicenter survey performed by the AFC-HC-2009 study group[J]. J Hepatol, 2012, 56(5): 1121-1128. DOI: 10.1016/j.jhep.2011.12.010.
[25]	MIYAZAKI M, KIMURA F, SHIMIZU H, et al. Extensive hilar bile duct resection using a transhepatic approach for patients with hepatic hilar bile duct diseases[J]. Am J Surg, 2008, 196(1): 125-129. DOI: 10.1016/j.amjsurg.2007.04.020.
[26]	XIONG J, NUNES QM, HUANG W, et al. Major hepatectomy in Bismuth types I and Ⅱ hilar cholangiocarcinoma[J]. J Surg Res, 2015, 194(1): 194-201. DOI: 10.1016/j.jss.2014.10.029.
[27]	CHEN YJ, ZHOU R. Application of mesohepatectomy with caudate lobectomy in hilar cholangiocarcinoma[J]. Chin J Dig Surg, 2021, 20(1): 52-58. DOI: 10.3760/cma.j.cn115610-20201116-00727. 陈亚进, 周睿. 中肝叶联合尾状叶切除术在肝门部胆管癌中的应用[J]. 中华消化外科杂志, 2021, 20(1) : 52-58. DOI: 10.3760/cma.j.cn115610-20201116-00727.
[28]	IKEYAMA T, NAGINO M, ODA K, et al. Surgical approach to Bismuth type I and Ⅱ hilar cholangiocarcinomas: Audit of 54 consecutive cases[J]. Ann Surg, 2007, 246(6): 1052-1057. DOI: 10.1097/SLA.0b013e318142d97e.
[29]	WANG H, YAO XX, QIAO SX. Controversies over the extent of surgical resection for hilar cholangiocarcinoma and research advances in diagnosis and treatment[J]. J Clin Hepatol, 2020, 36(3): 704-707. DOI: 10.3969/j.issn.1001-5256.2020.03.053. 汪宏, 姚小晓, 乔士兴. 肝门部胆管癌手术切除范围的争议及诊疗进展[J]. 临床肝胆病杂志, 2020, 36(3): 704-707. DOI: 10.3969/j.issn.1001-5256.2020.03.053.
[30]	NIMURA Y, HAYAKAWA N, KAMIYA J, et al. Hepatic segmentectomy with caudate lobe resection for bile duct carcinoma of the hepatic hilus[J]. World J Surg, 1990, 14(4): 535-543; discussion 544. DOI: 10.1007/BF01658686.
[31]	MANSOUR JC, ALOIA TA, CRANE CH, et al. Hilar cholangiocarcinoma: Expert consensus statement[J]. HPB (Oxford), 2015, 17(8): 691-699. DOI: 10.1111/hpb.12450.
[32]	KIM SJ, KIM MJ, HAN JS, et al. Prediction of recurrence with KRAS mutational burden using ultrasensitive digital polymerase chain reaction of radial resection margin of resected pancreatic ductal adenocarcinoma[J]. Pancreas, 2019, 48(3): 400-411. DOI: 10.1097/MPA.0000000000001255.