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Incidence and Prognosis of Subsequent Cholangiocarcinoma in Patients with Hepatic Resection for Bile Duct Stones

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Abstract

Background and Aim

Cholangiocarcinoma (CCA) often develops after the hepatic resection for hepatolithiasis as well as indwelling it. We studied the incidence and prognosis of subsequent CCA in patients with hepatolithiasis in South Korea.

Methods

We identified individuals with diagnosed CCA at the time of or after surgery, during 2002–2016, from the Korean National Health Insurance. The incidences and survival rates of subsequent CCA were analyzed and compared with concomitant CCA. The standardized incidence ratios (SIRs) of CCA in this cohort were evaluated in the standard Korean population. All data were stratified by the presence of intrahepatic or extrahepatic CCA, age and sex.

Results

Of the 7852 patients with hepatectomy for BDS, 433 (5.84%) had concomitant CCA. Over the 12-year follow-up, 107 of 7419 (1.98%) patients were diagnosed with subsequent CCA. Patients with hepatic resection for BDS revealed higher SIRs for subsequent CCA (12.89, 95% CI 10.96–15.15) in cases of both intrahepatic CCA (13.40, 10.55–17.02) and extrahepatic CCA (12.42, 9.98–15.46). The median survival time for subsequent CCA was 0.87 years, while that for concomitant CCA was 2.79 years. Having subsequent CCA (HR 2.71, 95% CI 2.17–3.40) and being male (HR 1.28, 1.05–1.57) were related to a shorter survival time. The CCA site and age at CCA diagnosis were not related to prognoses.

Conclusions

Subsequent CCA developed in 2% of the patients with hepatic resection for benign BDS until 10 years and was associated with poorer prognoses than concomitant CCA. Future studies focused on the long-term surveillance for CCA in such patients are needed.

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Author notes

  1. Hyun Jung Kim and Tae Uk Kang have contributed equally to this work.

Authors and Affiliations

  1. Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea

    Hyun Jung Kim & Hyeong Sik Ahn

  2. Health Insurance Policy Research Institute, National Health Insurance Service, Wonju, Korea

    Tae Uk Kang

  3. School of Sociology and Anthropology, University of Ottawa, Ottawa, Canada

    Heather Swan

  4. Department of Public Health, Graduate School, Korea University, Seoul, Korea

    Min Ji Kang

  5. Department of Internal Medicine, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Seoul, Korea

    Nayoung Kim

  6. Department of Internal Medicine, Chungbuk National University College of Medicine and Chungbuk National University Hospital, 1 Chungdae-ro, Seowon-gu, Cheongju, 28644, Korea

    Seon Mee Park

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  1. Hyun Jung Kim
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Correspondence to Seon Mee Park.

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Kim, H.J., Kang, T.U., Swan, H. et al. Incidence and Prognosis of Subsequent Cholangiocarcinoma in Patients with Hepatic Resection for Bile Duct Stones. Dig Dis Sci 63, 3465–3473 (2018). https://doi.org/10.1007/s10620-018-5262-6

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  • DOI: https://doi.org/10.1007/s10620-018-5262-6

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