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Hepatectomy for Peripheral Cholangiocarcinoma in Elderly Patients

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Abstract

Background

Peripheral cholangiocarcinoma (CCC) is less common than hepatocellular carcinoma. Little is known about CCC patients older than 70 years who have undergone hepatectomy.

Methods

Between 1977 and 2004, the clinical features of 33 elderly CCC patients (>70 years old) undergoing hepatectomy were reviewed, and 185 CCC patients younger than 70 years (younger CCC) were used for comparison.

Results

A total of 218 CCC patients undergoing hepatectomy were investigated with ages ranging from 28 to 93 years (median, 59.0 years). The elderly and younger CCC groups had a similar sex ratio and a similar positive rate of carcinoembryonic antigen (CEA) and CA19-9. A similar rate of hepatolithiasis, mucobilia, papillary pattern, stage distribution, curative hepatectomy, surgical morbidity, and mortality for CCC were also observed between the two groups. During a follow-up duration ranging from 1.1 to 145.0 months (median, 11.7 months), elderly CCC and younger CCC patients had similar prognoses after hepatectomy (P = .827). Elderly CCC patients with a low CEA level, an intraductal papillary growth pattern, curative hepatectomy, and postoperative chemotherapy tended to have favorable survival. However, elderly CCC patients with a low CEA level independently showed favorable survival.

Conclusions

Hepatectomy is feasible for selected elderly CCC patients. Elderly CCC patients undergoing hepatectomy had clinicopathologic features and prognoses similar to those of patients younger than 70 years undergoing hepatectomy. Elderly CCC patients with a low CEA level, intraductal papillary growth pattern, curative hepatectomy, and postoperative chemotherapy tended to have favorable survival. However, elderly CCC patients with low CEA level independently showed favorable survival.

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Authors and Affiliations

  1. Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University, 5 Fu-Hsing Street, Kwei-Shan, Taoyuan, Taiwan

    Chun-Nan Yeh MD, Yi-Yin Jan MD, FACS & Miin-Fu Chen MD, FACS

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  1. Chun-Nan Yeh MD
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  2. Yi-Yin Jan MD, FACS
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  3. Miin-Fu Chen MD, FACS
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Correspondence to Yi-Yin Jan MD, FACS.

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Yeh, CN., Jan, YY. & Chen, MF. Hepatectomy for Peripheral Cholangiocarcinoma in Elderly Patients. Ann Surg Oncol 13, 1553–1559 (2006). https://doi.org/10.1245/s10434-006-9085-x

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  • DOI: https://doi.org/10.1245/s10434-006-9085-x

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