• Fumihiko Miura, Keiji Sano, Hodaka Amano, Naoyuki Toyota, Keita Wada, Masahiro Yoshida, Koichi Hayano, Hisahiro Matsubara, and Tadahiro Takada.
• Department of Surgery, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan. f-miura@med.teikyo-u.ac.jp.
• J Hepatobiliary Pancreat Sci. 2015 Apr 1; 22 (4): 294-300.

BackgroundThe concept of borderline resectability has not yet been introduced for extrahepatic cholangiocarcinoma (ECC). In this study, the surgical results of ECC patients were analyzed to clarify the implications of surgery for distal ECC with portal vein (PV) invasion as a preliminary step for the introduction of the concept of borderline resectability.MethodsThe clinicopathological data of 129 patients who had undergone pancreatoduodenectomy of distal ECC were reviewed retrospectively. Combined PV resection was performed in 10 patients. The clinicopathological variables were evaluated using univariate and multivariate analyses.ResultsPathological PV invasion was observed in eight of the 129 patients. The survival rates of patients with PV invasion were significantly poorer than those of patients without PV invasion: 3 and 5 years after surgery, 17% and 0% versus 50% and 39% (P < 0.001), respectively. Presence of pancreatic or PV invasion, tumor progression, nodal status, and residual tumor were significant prognostic factors on univariate analysis. On multivariate analysis, PV invasion was the only significant independent predictive factor of a poor prognosis.ConclusionsPV invasion of distal ECC should be regarded as indicating borderline resectability.© 2014 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

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