KEY TAKEAWAYS
- The study aimed to evaluate the impact of BDR on prognosis in patients with extrahepatic BDTT.
- Resection combined with choledochotomy may provide additional benefits for patients with HCC-BDTT.
Surgical therapy is considered the most effective treatment for hepatocellular carcinoma (HCC) with bile duct tumor thrombus (BDTT). However, the decision to perform bile duct resection (BDR) remains a topic of debate.
Xi Yu and the team aimed to compare the impact of BDR on the prognosis of patients with extrahepatic BDTT to evaluate its effectiveness.
Researchers collected data from 111 patients with HCC and extrahepatic BDTT who underwent radical hepatectomy between June 1, 2004, and December 31, 2021. Patients were categorized into 2 groups: those who had hepatectomy with BDR (BDR group) and those without BDR (NBDR group).
They used inverse probability of treatment weighting (IPTW) to balance the groups and reduce bias. Prognosis was compared between the groups using a Cox regression model to identify independent risk factors affecting outcomes.
The results revealed 38 patients in the BDR group and 73 in the NBDR group. Before and after IPTW, OS, RFS, and intraoperative blood loss showed no significant differences between the groups (all P >0.05). Before IPTW, the NBDR group had a shorter median postoperative hospital stay (P=0.046) and fewer postoperative complications (P=0.014). After IPTW, there was no difference in hospital stay between the groups (P>0.05), but the NBDR group still had lower complication grades (P=0.046).
Univariate analysis linked TNM stage and portal vein tumor thrombus (PVTT) with overall survival (OS). Preoperative AFP level, TNM stage, and prognostic nutritional index (PNI) were associated with recurrence-free survival (RFS). Multivariate analysis identified tumor TNM stage as an independent risk factor for OS, and TNM stage, PNI, and AFP as independent predictors of RFS.
The study concluded that for HCC-BDTT patients, hepatocellular carcinoma resection combined with choledochotomy to remove the tumor thrombus may offer additional benefits.
The study was supported by the Natural Science Foundation of Guangdong Province.
Source: https://pubmed.ncbi.nlm.nih.gov/39112950/
Yu X, Liang QZ, Wang JL, et al. (2024). “Effect of bile duct resection on the prognosis of patients with hepatocellular carcinoma combined with extrahepatic bile duct tumor thrombus.” BMC Cancer. 2024 Aug 8;24(1):969. doi: 10.1186/s12885-024-12717-5. PMID: 39112950; PMCID: PMC11308446.
