Skip to main content

Advertisement

SpringerLink
Log in

Radiological findings and surgical outcomes of pulmonary metastases originating from biliary tract carcinoma

  • Original Article
  • Published:
General Thoracic and Cardiovascular Surgery Aims and scope Submit manuscript

Abstract

Purpose

Metastasis to the lungs arising from biliary tract carcinoma (BTC) is extremely rare, and the patient characteristics and prognosis are not well known. We aimed to identify the imaging findings of pulmonary metastases originating from BTC and the eligible indications for surgical treatment.

Methods

Fifteen patients who underwent pulmonary resection for metastases originating from BTC were retrospectively analyzed.

Results

The primary sites included cholangiocarcinoma (n = 12) and gallbladder carcinoma (n = 3), and all cases were histologically diagnosed as well to moderately differentiated adenocarcinomas. The median disease-free interval between resection for the primary site and the detection of pulmonary metastasis was 30 months (range 0–144 months). Nine patients had a single lesion, and six had multiple lesions. As features of pulmonary lesions on thin-section computed tomography (CT), many appeared as solid nodules with smooth margins, whereas six lesions were concomitant with spiculation or pleural indentation, three with air bronchogram or ground-glass attenuation, and one with intra-tumoral cavity, and six cases with solitary pulmonary lesion were diagnosed as primary lung cancer before metastasectomy. The 3-year survival rate in the 11 patients who underwent complete metastasectomy was 45%. A disease-free interval of more than 3 years (p = 0.03) and single lesion (p < 0.01) were significant prognostic factors.

Conclusions

The CT findings of pulmonary metastases from BTCs sometimes resemble the characteristic findings of primary lung cancer. A long disease-free interval and single lesion are therefore considered to be good surgical indicators.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Nagino M, Ebata T, Yokoyama Y, Igami T, Sugawara G, Takahashi Y, et al. Evolution of surgical treatment for perihilar cholangiocarcinoma: a single-center 34-year review of 574 consecutive resections. Ann Surg. 2013;258:129–40.

    Article  Google Scholar 

  2. DeOliveira ML, Cunningham SC, Cameron JL, Kamangar F, Winter JM, Lillemoe KD, et al. Cholangiocarcinoma: thirty-one-year experience with 564 patients at a single institution. Ann Surg. 2007;245:755–62.

    Article  Google Scholar 

  3. Shimada M, Yamashita Y, Aishima S, Shirabe K, Takenaka K, Sugimachi K. Value of lymph node dissection during resection of intrahepatic cholangiocarcinoma. Br J Surg. 2001;88:1463–6.

    Article  CAS  Google Scholar 

  4. Saiura A, Yamamoto J, Kokudo N, Koga R, Seki M, Hiki N, et al. Intrahepatic cholangiocarcinoma: analysis of 44 consecutive resected cases including 5 cases with repeat resections. Am J Surg. 2011;201:203–8.

    Article  Google Scholar 

  5. Ebata T, Yokoyama Y, Igami T, Sugawara G, Takahashi Y, Nimura Y, et al. Hepatopancreatoduodenectomy for cholangiocarcinoma: a single-center review of 85 consecutive patients. Ann Surg. 2012;256:297–305.

    Article  Google Scholar 

  6. Weber SM, Jarnagin WR, Klimstra D, et al. Intrahepatic cholangiocarcinoma: resectability, recurrence pattern, and outcomes. J Am Coll Surg. 2001;193:384–91.

    Article  CAS  Google Scholar 

  7. Takahashi Y, Ebata T, Yokoyama Y, Igami T, Sugawara G, Mizuno T, et al. Surgery for recurrent biliary tract cancer: a single-center experience with 74 consecutive resections. Ann Surg. 2015;262:121–9.

    Article  Google Scholar 

  8. Robinson LA, Tanvetyanon T, Springett G, Fontaine J, Toloza E, Hodul P, et al. Pulmonary metastasectomy for suspected pancreaticobiliary cancer. J Thorac Cardiovasc Surg. 2016;152:75–82.

    Article  Google Scholar 

  9. Yamada M, Ebata T, Yokoyama Y, Igami T, Sugawara G, Mizuno T, et al. Pulmonary metastasis after resection of cholangiocarcinoma: incidence, resectability, and survival. World J Surg. 2017;41:1550–7.

    Article  Google Scholar 

  10. Miyazaki M, Ohtsuka M, Miyakawa S, Nagino M, Yamamoto M, Kokudo N et al (2015) Classification of biliary tract cancers established by the Japanese Society of Hepato-Biliary-Pancreatic Surgery: 3rd English edition. J Hepatobiliary Pancreat Sci 22:181–196

    Article  Google Scholar 

  11. Miyazaki M, Yoshitomi H, Miyakawa S, Uesaka K, Unno M, Endo I et al (2015) Clinical practice guidelines for the management of biliary tract cancers 2015: the 2nd English edition. J Hepatobiliary Pancreat Sci 22:249–273

    Article  Google Scholar 

  12. Saxena A, ChuaTC, Chu FC, Morris DL (2011) Improved outcomes after aggressive surgical resection of hilar cholangiocarcinoma: a critical analysis of recurrence and survival. Am J Surg 202:310–320.

    Article  Google Scholar 

  13. Girard P, Baldeyrou P, Le Chevalier T, Lemoine G, Tremblay C, Spielmann M, et al. Surgical resection of pulmonary metastases: up to what number? Am J Respir Crit Care Med. 1994;149:469–76.

    Article  CAS  Google Scholar 

  14. Rena O, Davoli F, Boldorini R, Roncon A, Baietto G, Papalia E, et al. The solitary pulmonary nodule in patients with previous cancer history: results of surgical treatment. Eur J Surg Oncol. 2013;39:1248–53.

    Article  CAS  Google Scholar 

  15. Primack SL, Lee KS, Logan PM, Miller RR, Müller NL. Bronchogenic carcinoma: utility of CT in the evaluation of patients with suspected lesions. Radiology. 1994;193:795–800.

    Article  CAS  Google Scholar 

  16. Siegelman SS, Khouri NF, Leo FP, Fishman EK, Braverman RM, Zerhouni EA. Solitary pulmonary nodules: CT assesment. Radiology. 1986;160:307–12.

    Article  CAS  Google Scholar 

  17. Way TW, Sahiner B, Chan HP, Hadjiiski L, Cascade PN, Chughtai A, et al. Computer-aided diagnosis of pulmonary nodules on CT scans: improvement of classification performance with nodule surface features. Med Phys. 2009;36:3086–98.

    Article  Google Scholar 

  18. Park SY, Kim BH, Kim JH, Lee S, Kang GH. Panels of immunohistochemical markers help determine primary sites of metastatic adenocarcinoma. Arch Pathol Lab Med. 2007;131:1561–7.

    CAS  PubMed  Google Scholar 

  19. Javle M, Lowery M, Shroff RT, Weiss KH, Springfeld C, Borad MJ, et al. Phase II study of BGJ398 in patients With FGFR-altered advanced cholangiocarcinoma. J Clin Oncol. 2018;36:276–82.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Thoracic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan

    Koji Kawaguchi, Tetsuo Taniguchi, Takayuki Fukui, Shota Nakamura & Kohei Yokoi

  2. Division of Thoracic Surgery, Komaki City Hospital, Komaki, Japan

    Tetsuo Taniguchi

Authors
  1. Koji Kawaguchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tetsuo Taniguchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Takayuki Fukui
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shota Nakamura
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kohei Yokoi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Koji Kawaguchi.

Ethics declarations

Conflict of interest

The authors declare no conflicts of interest in association with this study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kawaguchi, K., Taniguchi, T., Fukui, T. et al. Radiological findings and surgical outcomes of pulmonary metastases originating from biliary tract carcinoma. Gen Thorac Cardiovasc Surg 67, 962–968 (2019). https://doi.org/10.1007/s11748-019-01122-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11748-019-01122-6

Keywords

Search

Navigation