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- 저자 : Tomoki Ebata (검색결과 3 건)
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Resection-Based Strategy for Type IV Perihilar Cholangiocarcinoma De Novo’
( Tomoki Ebata ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1
Background: Type IV perihilar cholangiocarcinomas have traditionally been treated as unresectable disease and a subset has been considered as candidate for liver transplantation. However, little is known about the outcome after resection-based strategy. Method: Between 2006 and 2015, 332 consecutive patients with type IV tumor were treated. Their medical records were retrospectively reviewed. Results: No patients had primary sclerosing cholangitis or liver fluke infection, and only one patient had hepatolithiasis. Therefore, almost all of the 332 patients had de novo perihilar cholangiocarcinoma. Of them, 216 (65%) patients underwent resection. Left hepatic trisectionectomy was the most common procedure (n=112). The combined vascular resection was performed in 131 patients. In median, the operating time was 607 minutes, and blood loss was 1357 mL. Clavien grade III or more complications developed in 90 (42%) patients, and 4 (2%) patients died of complication within 90 days. The survival rate for the resected group was significantly better than that for the unresected group (33% vs. 2% at 5 years; P<0.001). Resected patients with pN0M0 disease showed a favourable survival with a 5-year survival rate of 53%. Percutaneous transhepatic biliary drainage, blood transfusion, lymph node metastasis, and distant metastasis were identified as independent negative prognostic factors. Conclusion: Although resection for type IV tumor can be performed with low mortality and offers a better survival probability in selected patients. Therefore, the traditional unresectable scenario for type IV perihilar cholangiocarcinoma de novo should be revised.
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Impact of sarcopenia on biliary drainage during neoadjuvant therapy for pancreatic cancer
Kunio Kataoka,Eizaburo Ohno,Takuya Ishikawa,Kentaro Yamao,Yasuyuki Mizutani,Tadashi Iida,Hideki Takami,Osamu Maeda,Junpei Yamaguchi,Yukihiro Yokoyama,Tomoki Ebata,Yasuhiro Kodera,Hiroki Kawashima 대한소화기내시경학회 2024 Clinical Endoscopy Vol.57 No.1
Background/Aims: Since the usefulness of neoadjuvant chemo(radiation) therapy (NAT) for pancreatic cancer has been demonstrated, recurrent biliary obstruction (RBO) in patients with pancreatic cancer with a fully covered self-expandable metal stent (FCSEMS) during NAT is expected to increase. This study investigated the impact of sarcopenia on RBO in this setting. Methods: Patients were divided into normal and low skeletal muscle index (SMI) groups and retrospectively analyzed. Patient characteristics, overall survival, time to RBO (TRBO), stent-related adverse events, and postoperative complications were compared between the two groups. A Cox proportional hazard model was used to identify the risk factors for short TRBO. Results: A few significant differences were observed in patient characteristics, overall survival, stent-related adverse events, and postoperative complications between 38 patients in the normal SMI group and 17 in the low SMI group. The median TRBO was not reached in the normal SMI group and was 112 days in the low SMI group (p=0.004). In multivariate analysis, low SMI was the only risk factor for short TRBO, with a hazard ratio of 5.707 (95% confidence interval, 1.148–28.381; p=0.033). Conclusions: Sarcopenia was identified as an independent risk factor for RBO in patients with pancreatic cancer with FCSEMS during NAT.
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