关于肝门周围胆管癌新的可切除性分类的全国共识——一种改进的德尔菲方法。

IF 3.5 2区医学 Q2 ONCOLOGY

Ejso Pub Date : 2025-02-01 DOI:10.1016/j.ejso.2023.107117

Lynn E. Nooijen , Marieke T. de Boer , Andries E. Braat , Maxime Dewulf , Marcel den Dulk , Jeroen Hagendoorn , Frederik J.H. Hoogwater , Hwai-Ding Lam , Quintus Molenaar , Ulf Neumann , Robert J. Porte , Rutger-Jan Swijnenburg , Babs Zonderhuis , Geert Kazemier , Heinz-josef Klümpen , Thomas van Gulik , Bas Groot Koerkamp , Joris I. Erdmann

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引用次数: 0

摘要

背景：目前，还没有关于潜在可切除、交界性或不可切除的肝门周围胆管癌（pCCA）的实用定义。本研究的目的是确定在未来的新辅助或诱导治疗研究中使用的患者分类标准。方法：采用改良的DELPHI方法，邀请荷兰所有三级转诊中心的肝胆外科医生参与本研究。在五次在线会议上，讨论了决定可切除性的预定义因素以及与手术可切除性和可操作性有关的其他因素。结果：五次在线会议共作了52次发言。经过两次调查，63%的问题达成了共识。主要共识包括关于潜在可切除性的定义。1）可明确切除：未来肝残余物（FLR）无血管受累（≤90°），预期可进行胆道根治性切除。2）明显不可切除：FLR不可重建的静脉和/或动脉受累，或无可行的根治性胆道切除术。3）边界线可切除：介于明确可切除和明确不可切除疾病之间的所有患者。结论：这项DELPHI研究产生了一种实用和适用的可切除性，或者更准确的可探索性分类，可用于对患者进行分类，以用于未来的新辅助治疗研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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National consensus on a new resectability classification for perihilar cholangiocarcinoma - A modified Delphi method

Background

Currently, no practical definition of potentially resectable, borderline or unresectable perihilar cholangiocarcinoma (pCCA) is available. Aim of this study was to define criteria to categorize patients for use in a future neoadjuvant or induction therapy study.

Method

Using the modified DELPHI method, hepatobiliary surgeons from all tertiary referral centers in the Netherlands were invited to participate in this study. During five online meetings, predefined factors determining resectability and additional factors regarding surgical resectability and operability were discussed.

Results

The five online meetings resulted in 52 statements. After two surveys, consensus was reached in 63% of the questions. The main consensus included a definition regarding potential resectability. 1) Clearly resectable: no vascular involvement (≤90°) of the future liver remnant (FLR) and expected feasibility of radical biliary resection. 2) Clearly unresectable: non-reconstructable venous and/or arterial involvement of the FLR or no feasible radical biliary resection. 3) Borderline resectable: all patients between clearly resectable and clearly unresectable disease.

Conclusion

This DELPHI study resulted in a practical and applicable resectability, or more accurate, an explorability classification, which can be used to categorize patients for use in future neoadjuvant therapy studies.

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来源期刊

Ejso 医学-外科

CiteScore

6.40

自引率

2.60%

发文量

1148

审稿时长

41 days

期刊介绍： JSO - European Journal of Surgical Oncology ("the Journal of Cancer Surgery") is the Official Journal of the European Society of Surgical Oncology and BASO ~ the Association for Cancer Surgery. The EJSO aims to advance surgical oncology research and practice through the publication of original research articles, review articles, editorials, debates and correspondence.