title: Patterns of initial disease recurrence after resection of biliary tract cancer.
abstract: OBJECTIVE
  This study aimed to provide further insights into the indications for adjuvant therapeutic strategies via analysis of the sites of initial recurrence after resection of gallbladder cancer (GBC) and intrahepatic (IHC) and extrahepatic cholangiocarcinoma (EHC).
  
  
  METHODS
  Patients with biliary tract cancer who underwent potentially curative resection were identified from the database. Sites of initial disease recurrence were categorized as locoregional or distant.
  
  
  RESULTS
  Between March 2001 and April 2009, 231 patients underwent curative resection. Initial GBC and IHC recurrence involving a distant site occurred in 70.8 and 86.8% patients, respectively, compared to 56.9% patients with EHC (p = 0.002). The median time to disease recurrence (TTR) was shorter among the GBC and IHC groups compared with that in EHC patients (6.3 and 6.7 vs. 13.1 months, respectively; p = 0.003). Moreover, median times to distant recurrence in GBC and IHC groups were shorter than that in EHC (5.8 and 6.5 vs. 14.1 months, respectively; p = 0.002).
  
  
  CONCLUSIONS
  After resection, recurrent GBC and IHC are more likely to involve a distant site and are associated with significantly shorter TTR than recurrent EHC. These findings suggest that an adjuvant therapeutic strategy targeting distant disease is likely to have a signiﬁcant impact on the overall management of GBC and IHC.
authors: Center for Liver Cancer, National Cancer Center, Goyang, Republic of Korea.
authors: Se Jin
authors: SJ
authors: Jung
authors: Sang Myung
authors: SM
authors: Woo
authors: Hyung Ki
authors: HK
authors: Park
authors: Woo Jin
authors: WJ
authors: Lee
authors: Mi Ah
authors: MA
authors: Han
authors: Sung-Sik
authors: SS
authors: Han
authors: Seong Hoon
authors: SH
authors: Kim
authors: Sang-Jae
authors: SJ
authors: Park
authors: Tae Hyun
authors: TH
authors: Kim
authors: Young Hwan
authors: YH
authors: Koh
authors: Eun Kyung
authors: EK
authors: Hong
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001653:Bile Ducts, Intrahepatic; D001661:Biliary Tract Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D018281:Cholangiocarcinoma / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005706:Gallbladder Neoplasms / Q000473:pathology / Q000601:surgery; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology* / Q000601:surgery; D013997:Time Factors