ИСТИНА

• Охват: Международная
• Даты проведения: 3-6 июля 2019
• Место проведения: Centre de Convencions Internacional de Barcelona (CCIB) Plaça de Willy Brandt 11-14 08019 Barcelona, Spain, Spain
• Организатор:
  ESMO Gastrointestinal Cancer
• Веб-сайт: https://www.hmpgloballearningnetwork.com/site/onc
• Описание конференции:

  Background and Aims: to improve the results of surgical and combined treatment of patients (pts) with cholangiocarcinoma (CCA) Method: from 1998-2017 a total of 263 pts with bile duct cancer underwent surgery. 128 liver resections were performed for pts with intrahepatic cholangiocarcinoma (iCCA), 101 of them were extensive (78.9%) and 27 were slight (21.1%). Additionally to liver resection extrahepatic bile ducts cutting was performed in 11 pts (8.6%), vascular resection - in 6 cases (4.7%), 19 pts underwent resection of other organs (14.8%). The III-IV stages were observed in 83.6% (n=107). The lymph node (LN) involvement was suggested in 37 pts (28.9%). R0 resection rate was 81.3% (n=104). All pts with distal bile duct cancer (n=77) underwent Whipple-procedure, portal vein was resected in 8 pts (10.4%). The I-II stages were more common - 77.2% (n = 60). R0 resection was 83.1% (n = 64). The LNl involvement was suggested in 18 pts (23.4%).There were 58 pts with hilar CCA. The III-IV stages (TNM) were prevalent - 72,4% (n = 42), the III-IV (Bismut) stages were observed in 87,9% (n = 51) The most of pts with Klatskin tumor (89.7%, n=52) underwent liver resection with extrahepatic bile ducts resection. R0 resection rate was 82.7%. The bile duct resections alone were performed in 6 cases (10.3%), R0 resection was achieved in 1 case only (16,7%). Portal vein resection was required in 16 pts (27.9%). LN positive revealed in 22 pts (37,9%). Among all pts with CCA 90 (34.2%) pts received postoperative chemotherapy, in 74 cases - after R0 resection. Results: The postoperative complications occurred in 172 cases (65.4%), postoperative mortality rate was 7,2% (n=19). Five- and ten-year survival rates were 36.6% and 17.7% respectively. Median OS was 30 months (mo). LT results were significantly better in R0-resection group than in an R1-R2 group (the median OS was 37 mo and 20 mo respectively, p=0.01). The median OS in the group with LN metastasis was 26 month, compared with 46 mo in the group with negative LN (p=0.016). Adjuvant chemotherapy improved LT results in R0 resection group: the median OS in a branch with postoperative chemotherapy was 46 month, the median OS in surgery along branch was 30 mo (р=0.02), 5-year survival rates were 49.6% and 33% respectively. Multiple lesions (median is 40 mo vs 64, p=0.22) and jaundice (median is 38 mo vs 55, p=0.4) did not show adverse prognostic value in the group of pts with iCCA. Conclusion: It is important to strive to perform a radical resection with sufficient LN dissection and, if necessary, with resection of nearby involved structures. LN dissection must be have routinely used. Standard volume of surgery for a Klatskin tumor is resection of bile ducts in combination with extensive liver resection. In case of iCCA, multiple liver lesions and extrahepatic bile ducts involvement are not contraindications to operation. Adjuvant chemotherapy significantly improves long-term outcomes.

• Добавил в систему: Поляков Александр Николаевич

Доклады:

• 2019 Surgical and combined treatment for patients with cholangiocarcinoma - the experience of FSBI “N.N. Blokhin National Medical Research Center of Oncology” (Стендовый)
• Автор: Поляков А.Н.