title: The true prognosis of resected distal cholangiocarcinoma.
abstract: BACKGROUND
  Prognosis of distal cholangiocarcinoma (DCC) after pancreaticoduodenectomy (PD) remains poorly assessed. The aims of this study were to describe the oncological results of PD in DCC and to compare its prognosis to pancreatic ductal adenocarcinoma (PDAC).
  
  
  METHODS
  All PD for periampullary carcinoma performed between January 2000 and March 2013 were extracted from a prospective database. Risk factors likely to influence overall (OS) and disease-free (DFS) survivals of DCC were assessed by multivariable analyses. The DCC and PDAC prognoses were compared after matching using propensity score (nearest neighbor matching).
  
  
  RESULTS
  Of the 290 patients analyzed, 56 had DCC, with a mean age of 65 ± 15 years. The median OS was 36.9 months. Recurrence occurred in 35 patients (67%), mostly in the liver (37%). The median DFS was 14.6 months. Combined organ resection was an independent risk factor for worse OS and DFS (P = 0.01 and P = 0.001, respectively). Matching analysis found no significant difference between DCC and PDAC in terms of OS (P = 0.284) or DFS (P = 0.438).
  
  
  CONCLUSIONS
  This first propensity analysis demonstrated that DCC and PDAC have the same prognosis, linked to the high rate of early recurrence, particularly associated with the need for combined organ resection. J. Surg. Oncol. 2016;113:575-580. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Service de Chirurgie Hépatobiliaire et Digestive, CHU Rennes, Rennes, France.|Faculté de médecine, Université Rennes1, Rennes, France.|INSERM, U991, Foie métabolismes et cancer, Rennes, France.
authors.forename: Laetitia
authors.initials: L
authors.lastname: Courtin-Tanguy
authors.affiliation: Service de Chirurgie Hépatobiliaire et Digestive, CHU Rennes, Rennes, France.|Faculté de médecine, Université Rennes1, Rennes, France.|INSERM, U1414, Centre d'investigation Clinique, Rennes, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Rayar
authors.affiliation: Service de Chirurgie Hépatobiliaire et Digestive, CHU Rennes, Rennes, France.|Faculté de médecine, Université Rennes1, Rennes, France.|INSERM, U991, Foie métabolismes et cancer, Rennes, France.
authors.forename: Damien
authors.initials: D
authors.lastname: Bergeat
authors.affiliation: Service de Chirurgie Hépatobiliaire et Digestive, CHU Rennes, Rennes, France.|Faculté de médecine, Université Rennes1, Rennes, France.|INSERM, U991, Foie métabolismes et cancer, Rennes, France.
authors.forename: Aude
authors.initials: A
authors.lastname: Merdrignac
authors.affiliation: Service de Chirurgie Hépatobiliaire et Digestive, CHU Rennes, Rennes, France.|Faculté de médecine, Université Rennes1, Rennes, France.|INSERM, U991, Foie métabolismes et cancer, Rennes, France.
authors.forename: Yann
authors.initials: Y
authors.lastname: Harnoy
authors.affiliation: Service de Chirurgie Hépatobiliaire et Digestive, CHU Rennes, Rennes, France.|Faculté de médecine, Université Rennes1, Rennes, France.|INSERM, U1414, Centre d'investigation Clinique, Rennes, France.
authors.forename: Karim
authors.initials: K
authors.lastname: Boudjema
authors.affiliation: Service de Chirurgie Hépatobiliaire et Digestive, CHU Rennes, Rennes, France.|Faculté de médecine, Université Rennes1, Rennes, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Meunier
authors.affiliation: Service de Chirurgie Hépatobiliaire et Digestive, CHU Rennes, Rennes, France.|Faculté de médecine, Université Rennes1, Rennes, France.|INSERM, U991, Foie métabolismes et cancer, Rennes, France.|INSERM, U1414, Centre d'investigation Clinique, Rennes, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Sulpice
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D021441:Carcinoma, Pancreatic Ductal / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018281:Cholangiocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D057216:Propensity Score; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
keywords: distal cholangiocarcinoma; prognosis; recurrence