胆管癌肺転移に対する肺切除術：後ろ向き症例シリーズ
Yuhi Yoshizaki1, Nobuyuki Takemura1, Takashi Kokudo1
1Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, National Centre for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan.
Introduction:
Cholangiocarcinoma (CCA) is associated with a high incidence of recurrence and patients occasionally develop pulmonary metastases. Systemic chemotherapy is the first-line treatment for unresectable or recurrent CCA. However, we have occasionally encountered cases of favorable prognosis following pulmonary resection for CCA metastases.
Materials And Methods:
Data from patients undergoing surgery for CCA between 2012 and 2021 were obtained from a prospectively maintained database. We retrospectively reviewed patients with pulmonary metastases from CCA, including those who underwent pulmonary resection and those who did not. Additionally, we described a representative case of repeated pulmonary resection with long-term survival.
Results:
Among 122 patients who underwent surgery for CCA with curative intent, 64 patients (52.5%) experienced recurrence, including 14 patients (11.5%) who developed pulmonary metastases. Of these, five underwent pulmonary resection, including 1 who received two resections. None of the patients experienced postoperative complications. With a median follow-up of 2.6 y, three patients remained alive without recurrence. A representative case achieved long-term survival after repeated pulmonary resections. The 5-y overall survival rates were significantly better in patients who underwent pulmonary resection than in those who did not (75.0% versus 0%, P = 0.011).
Conclusions:
Pulmonary resection may represent a feasible treatment option for carefully selected patients with pulmonary metastases from CCA.
