Zhoubné nádory mimojaterních žlučových cest

Česká verze

Authors: V. Třeška ¹; J. Fichtl ¹; J. Ferda ² ; J. Fínek ³; T. Skalický ¹; V. Liška ¹; P. Hošek ⁴
Authors place of work: Chirurgická klinika, Lékařská fakulta Univerzity Karlovy a Fakultní nemocnice v Plzni ¹; Klinika zobrazovacích metod, Lékařská fakulta Univerzity Karlovy a Fakultní nemocnice v Plzni ²; Onkologická a radioterapeutická klinika, Lékařská fakulta Univerzity Karlovy a Fakultní nemocnice v Plzni ³; Biomedicínské centrum Lékařské fakulty Univerzity Karlovy v Plzni ⁴
Published in the journal: Rozhl. Chir., 2022, roč. 101, č. 9, s. 428-435.
Category: Původní práce
doi: https://doi.org/10.33699/PIS.2022.101.9.428–435

Summary

Introduction: Biliary tract malignancies belong to very aggressive malignancies of the gastrointestinal tract. The only radical treatment is surgical resection which is possible only in a limited number of cases due to late diagnosis. The aim of this report was to present the experience of our own department with the diagnosis and treatment of these tumours.

Methods: In the years 2005–2021 radical (R0) resection was performed in 27 (28.4%) patients, the same number were managed only symptomatically and in 41 (43.2%) patients we used biliary stenting and external-internal drainage as the definitive procedure. Adjuvant oncological treatment was indicated in 16 (59.3%) of the radically operated and 49 (72.1%) of the non-operated patients.

Results: Median overall survival and median progression-free survival in the operated patients were 19.9 months and 15.7 months, respectively. Overall survival in the operated patients was significantly better (p<0.0001) than in patients managed palliatively. Median overall survival for drainage and palliative treatment was 5.8 and 3.6 months, respectively. Overall survival did not differ between symptomatic and drainage treatment (p<0.3383).

Conclusion: In addition to their histopathological aggressiveness, late diagnosis is the main cause of poor treatment outcomes in extrahepatic biliary tract malignancies. Treatment should be guided by a multidisciplinary team. Currently, there is a great development of endoscopic methods, which, together with further development of personalized oncological treatment, may bring improved results in the future. Surgical, radical treatment remains the method of choice with the best long-term results.

Keywords:

diagnosis – treatment – outcomes – extrahepatic bile duct malignancies

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