title: Outcomes after resection of occupational cholangiocarcinoma.
abstract: BACKGROUND
  Cholangiocarcinoma caused by exposure to 1,2-dichloropropane and/or dichloromethane is recognized as occupational cholangiocarcinoma. The aim of this study was to investigate the outcomes after resection of occupational cholangiocarcinoma to establish a treatment strategy for this disease.
  
  
  METHODS
  Clinicopathological findings and outcomes after surgical intervention in 20 patients with occupational cholangiocarcinoma were investigated.
  
  
  RESULTS
  Of 20 the patients, curative resection was performed in 16 patients. Three patients underwent radiation at the stump of the bile ducts. Adjuvant chemotherapy was performed in 12 patients. Biliary intraepithelial neoplasia, intraductal papillary neoplasm of the bile duct, and/or chronic bile duct injury was detected in most subjects. Intraabdominal infection developed after surgery in nine patients. Cholangiocarcinoma recurred in 12 of the 20 patients. The recurrent tumors in five patients developed at a different part of the bile duct from the primary tumor and a second resection was performed in four of these five patients.
  
  
  CONCLUSIONS
  The incidence of postoperative complications including intraabdominal infection was high in patients with occupational cholangiocarcinoma. Multicentric recurrence occurred not infrequently after surgery because the bile ducts had a high potential for the development of carcinoma. The aggressive treatment including second resection for the multicentric recurrence appeared to be effective.
authors.affiliation: Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan. m7696493@msic.med.osaka-cu.ac.jp.
authors.forename: Shoji
authors.initials: S
authors.lastname: Kubo
authors.affiliation: Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Shigekazu
authors.initials: S
authors.lastname: Takemura
authors.affiliation: Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Shogo
authors.initials: S
authors.lastname: Tanaka
authors.affiliation: Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Hiroji
authors.initials: H
authors.lastname: Shinkawa
authors.affiliation: Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kinoshita
authors.affiliation: Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Genya
authors.initials: G
authors.lastname: Hamano
authors.affiliation: Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Tokuji
authors.initials: T
authors.lastname: Ito
authors.affiliation: Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Koda
authors.affiliation: Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Takanori
authors.initials: T
authors.lastname: Aota
authors.affiliation: Department of Surgery, Ishikiriseiki Hospital, Higashi-osaka, Japan.
authors.forename: Takatsugu
authors.initials: T
authors.lastname: Yamamoto
authors.affiliation: Department of Gastroenterological Surgery and Oncology, Kitano Hospital, Tazuke Kofukai Medical Research Institute, Osaka, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Terajima
authors.affiliation: Department of Surgery, Tane General Hospital, Osaka, Japan.
authors.forename: Gorou
authors.initials: G
authors.lastname: Tachiyama
authors.affiliation: Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors.forename: Terumasa
authors.initials: T
authors.lastname: Yamada
authors.affiliation: Department of Hepato-Biliary-Pancreatic Surgery, National Hospital Organization, Osaka National Hospital, Osaka, Japan.
authors.forename: Shoji
authors.initials: S
authors.lastname: Nakamori
authors.affiliation: Department of Hepato-Biliary-Pancreatic Surgery, Osaka Red Cross Hospital, Osaka, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Arimoto
authors.affiliation: Department of Surgery, Nissay Hospital, Osaka, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Fujikawa
authors.affiliation: Department of Surgery, Graduate School of Medicine, Osaka University, Suita, Japan.
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Tomimaru
authors.affiliation: Artificial Organ and Transplantation Division, Department of Surgery, University of Tokyo, Tokyo, Japan.
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Sugawara
authors.affiliation: Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Kei
authors.initials: K
authors.lastname: Nakagawa
authors.affiliation: Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Michiaki
authors.initials: M
authors.lastname: Unno
authors.affiliation: Department of Surgery, Surgical Oncology and Science, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Mizuguchi
authors.affiliation: Department of Surgery, Fukuoka City Hospital, Fukuoka, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Takenaka
authors.affiliation: Department of Surgery and Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Kimura
authors.affiliation: Department of Surgery and Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Shirabe
authors.affiliation: Department of Hepato-Biliary-Pancreatic Surgery, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan.
authors.forename: Akio
authors.initials: A
authors.lastname: Saiura
authors.affiliation: Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center Hospital, Shizuoka, Japan.
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Uesaka
authors.affiliation: Department of Surgery, Kyoto Second Red Cross Hospital, Kyoto, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Taniguchi
authors.affiliation: Department of Surgery, Tokyo Metropolitan Health and Medical Treatment Corporation Toshima Hospital, Tokyo, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Fukuda
authors.affiliation: Department of Pathology, Tokyo Metropolitan Health and Medical Treatment Corporation Toshima Hospital, Tokyo, Japan.
authors.forename: Ja-Mun
authors.initials: JM
authors.lastname: Chong
authors.affiliation: Department of Diagnostic Pathology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kuwae
authors.affiliation: Department of Diagnostic Pathology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Ohsawa
authors.affiliation: Department of Human Pathology, Kanazawa University Graduate School of Medicine, Kanazawa, Japan.
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Sato
authors.affiliation: Department of Diagnostic Pathology, Shizuoka Cancer Center Hospital, Shizuoka, Japan.
authors.forename: Yasuni
authors.initials: Y
authors.lastname: Nakanuma
mesh_terms: D000328:Adult; D001650:Bile Duct Neoplasms / Q000139:chemically induced* / Q000473:pathology / Q000601:surgery; D001662:Biliary Tract Surgical Procedures / Q000379:methods / Q000401:mortality; D001707:Biopsy, Needle; D018281:Cholangiocarcinoma / Q000139:chemically induced* / Q000473:pathology / Q000601:surgery; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007564:Japan; D008297:Male; D008752:Methylene Chloride / Q000009:adverse effects*; D008875:Middle Aged; D009784:Occupational Diseases / Q000175:diagnosis / Q000601:surgery*; D016273:Occupational Exposure / Q000009:adverse effects*; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D008752:Methylene Chloride
keywords: Biliary intraepithelial neoplasia; Intraductal papillary neoplasm of the bile duct; Multicentric recurrence; Occupational cholangiocarcinoma; Postoperative complications