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- 저자 : Chandacham, Anchalee (검색결과 2 건)
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Clinical Benefit of Frozen Section of Proximal Bile Duct Margin in Perihilar Cholangiocarcinoma
( Lakkana Adireklarpwong ),( Sunhawitjunrungsee ),( Anon Chotirosniramit ),( Trichak Sandhu ),( Worakitti Lapisetepun ),( Tidarat Jirapongcharoenlap ),( Kamtone Chandacham ),( Kamtone Chandacham ),( N 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1
Aims: R0 resection is the best chance of prolonging the survival of cholangiocarcinoma patients. Frozen section analysis of duct margin often be used to determine bile duct in an attempt to achieve R0 resection, but the clinical benefit remains controversial. Methods: All 132 patients underwent hepatectomy for perihilar cholangiocarcinoma between January 2006, and December 2019 were analyzed into prospective and retrospective group. Resection status, the accuracy of the frozen section, surgical variables, prognostic factors, survival, and recurrence were evaluated. Results: R0 status in frozen section group was higher than non-frozen section group but not significant (48.72 vs 35.48 percent) (P=0.175). Median survival in both groups were 24 and 17 months that tend to be better in frozen section group although there were no statistically significant difference (P=0.25). And one-year survival rates were 65.38 and 67.57 percent. In all populations, the median survival of R0 resection patients was better than R1 resection patients (32 vs 13 months) (P=0.001). However, median survival of secondary R0 and R1 resection was not different (P=0.43). The median follow up time in frozen section and non frozen section group were 19.12 and 77.67 months. Conclusions: The clinical benefit of the frozen section of the proximal bile duct margin is still inconclusive. Intraoperative frozen section analysis tends to increase the number of R0 resection and prolong survival, although they were not significant. The frozen section should be done if possible for increasing R0 resection rate that has better survival.
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Intaraphet, Suthida,Kasatpibal, Nongyao,Siriaunkgul, Sumalee,Sogaard, Mette,Patumanond, Jayanton,Khunamornpong, Surapan,Chandacham, Anchalee,Suprasert, Prapaporn Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.9
Background: Clarifying the prognostic impact of histological type is an essential issue that may influence the treatment and follow-up planning of newly diagnosed cervical cancer cases. This study aimed to evaluate the prognostic impact of histological type on survival and mortality in patients with cervical squamous cell carcinoma (SCC), adenocarcinoma (ADC) and small cell neuroendocrine carcinoma (SNEC). Materials and Methods: All patients with cervical cancer diagnosed and treated at Chiang Mai University Hospital between January 1995 and October 2011 were eligible. We included all patients with SNEC and a random weighted sample of patients with SCC and ADC. We used competing-risks regression analysis to evaluate the association between histological type and cancer-specific survival and mortality. Results: Of all 2,108 patients, 1,632 (77.4%) had SCC, 346 (16.4%) had ADC and 130 (6.2%) had SNEC. Overall, five-year cancer-specific survival was 60.0%, 54.7%, and 48.4% in patients with SCC, ADC and SNEC, respectively. After adjusting for other clinical and pathological factors, patients with SNEC and ADC had higher risk of cancer-related death compared with SCC patients (hazard ratio [HR] 2.6; 95% CI, 1.9-3.5 and HR 1.3; 95% CI, 1.1-1.5, respectively). Patients with SNEC were younger and had higher risk of cancer-related death in both early and advanced stages compared with SCC patients (HR 4.9; 95% CI, 2.7-9.1 and HR 2.5; 95% CI, 1.7-3.5, respectively). Those with advanced-stage ADC had a greater risk of cancer-related death (HR 1.4; 95% CI, 1.2-1.7) compared with those with advanced-stage SCC, while no significant difference was observed in patients with early stage lesions. Conclusion: Histological type is an important prognostic factor among patients with cervical cancer in Thailand. Though patients with SNEC were younger and more often had a diagnosis of early stage compared with ADC and SCC, SNEC was associated with poorest survival. ADC was associated with poorer survival compared with SCC in advanced stages, while no difference was observed at early stages. Further tailored treatment-strategies and follow-up planning among patients with different histological types should be considered.
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