한국간담췌외과학회지 (Annals of Hepato-Biliary-Pancreatic Surgery)

  • 제27권3호
  • /
  • Pages.251-257
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  • 2023
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  • 2508-5778(pISSN)
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  • 2508-5859(eISSN)
한국간담췌외과학회 (The Korean Association of Hepato-Biliary-Pancreatic Surgery)
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Retrospective analysis of 8th edition American Joint Cancer Classification: Distal cholangiocarcinoma

  • Atish Darshan Bajracharya (Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Suniti Shrestha (Department of Pathology, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Hyung Sun Kim (Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Ji Hae Nahm (Department of Pathology, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Kwanhoon Park (Department of Surgery, National Health Insurance Service Ilsan Hospital) ;
  • Joon Seong Park (Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine)
  • 투고 : 2022.12.21
  • 심사 : 2023.02.14
  • 발행 : 2023.08.31
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초록

Backgrounds/Aims: This is a retrospective analysis of whether the 8th edition American Joint Committee on Cancer (AJCC) was a significant improvement over the 7th AJCC distal extrahepatic cholangiocarcinoma classification. Methods: In total, 111 patients who underwent curative resection of mid-distal bile duct cancer from 2002 to 2019 were included. Cases were re-classified into 7th and 8th AJCC as well as clinicopathological univariate and multivariate, and Kaplan-Meier survival curve and log rank were calculated using R software. Results: In patient characteristics, pancreaticoduodenectomy/pylorus preserving pancreaticoduodenectomy had better survival than segmental resection. Only lymphovascular invasion was found to be significant (hazard ratio 2.01, p = 0.039) among all clinicopathological variables. The 8th edition AJCC Kaplan Meier survival curve showed an inability to properly segregate stage I and IIA, while there was a large difference in survival probability between IIA and IIB. Conclusions: The 8th distal AJCC classification did resolve the anatomical issue with the T stage, as T1 and T3 showed improvement over the 7th AJCC, and the N stage division of the N1 and N2 category was found to be justified, with poorer survival in N2 than N1. Meanwhile, in TMN staging, the 8th AJCC was able differentiate between early stage (I and IIA) and late stage (IIB and III) to better explain the patient prognosis.

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참고문헌

  1. Banales JM, Marin JJG, Lamarca A, Rodrigues PM, Khan SA, Roberts LR, et al. Cholangiocarcinoma 2020: the next horizon in mechanisms and management. Nat Rev Gastroenterol Hepatol 2020;17:557-588.
  2. Postlewait LM, Ethun CG, Le N, Pawlik TM, Buettner S, Poultsides G, et al. Proposal for a new T-stage classification system for distal cholangiocarcinoma: a 10-institution study from the U.S. Extrahepatic Biliary Malignancy Consortium. HPB (Oxford) 2016;18:793-799.
  3. Hong SM, Pawlik TM, Cho H, Aggarwal B, Goggins M, Hruban RH, et al. Depth of tumor invasion better predicts prognosis than the current American Joint Committee on Cancer T classification for distal bile duct carcinoma. Surgery 2009;146:250-257.
  4. Hong SM, Cho H, Moskaluk CA, Yu E. Measurement of the invasion depth of extrahepatic bile duct carcinoma: an alternative method overcoming the current T classification problems of the AJCC staging system. Am J Surg Pathol 2007;31:199-206.
  5. Moon A, Choi DW, Choi SH, Heo JS, Jang KT. Validation of T stage according to depth of invasion and N stage subclassification based on number of metastatic lymph nodes for distal extrahepatic bile duct (EBD) carcinoma. Medicine (Baltimore) 2015;94:e2064.
  6. Jun SY, Sung YN, Lee JH, Park KM, Lee YJ, Hong SM. Validation of the Eighth American Joint Committee on cancer staging system for distal bile duct carcinoma. Cancer Res Treat 2019;51:98-111.
  7. Min KW, Kim DH, Son BK, Kim EK, Ahn SB, Kim SH, et al. Invasion depth measured in millimeters is a predictor of survival in patients with distal bile duct cancer: decision tree approach. World J Surg 2017;41:232-240.
  8. Min KW, Kim DH, Son BK, Moon KM, Kim EK, Oh YH, et al. Author correction: dual-organ invasion is associated with a lower survival rate than single-organ invasion in distal bile duct cancer: a multicenter study. Sci Rep 2018;8:12230. Erratum for: Sci Rep 2018;8:10826.
  9. Aoyama H, Ebata T, Hattori M, Takano M, Yamamoto H, Inoue M, et al. Reappraisal of classification of distal cholangiocarcinoma based on tumour depth. Br J Surg 2018;105:867-875.
  10. You Y, Shin YC, Choi DW, Heo JS, Shin SH, Kim N, et al. Proposed modification of staging for distal cholangiocarcinoma based on the lymph node ratio using Korean multicenter database. Cancers (Basel) 2020;12:762.