Rare Diseases Symptoms Automatic Extraction
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Optimal Indications for Additional Resection of the Invasive Cancer-Positive Proximal Bile Duct Margin in Cases of Advanced Perihilar Cholangiocarcinoma.
[cholangiocarcinoma]
The
survival
benefits
of
additional
resection
of
the
positive
proximal
ductal
margin
in
cases
of
perihilar
cholangiocarcinoma
remain
to
be
elucidated
.
The
purpose
of
this
retrospective
study
was
to
clarify
the
optimal
indications
for
additional
resection
of
the
invasive
cancer
-
positive
proximal
ductal
margin
(
PM
)
METHODS
:
All
patients
who
underwent
hepatectomy
for
perihilar
cholangiocarcinoma
between
2000
and
2011
were
analyzed
.
Surgical
variables
,
the
status
of
the
PM
,
prognostic
factors
,
and
survival
were
evaluated
.
A
total
of
224
patients
were
enrolled
.
Additional
resection
was
performed
in
52
of
75
positive
PMs
of
invasive
cancer
,
resulting
in
43
negative
PMs
.
The
survival
of
patients
with
a
negative
PM
treated
with
additional
resection
(
n
=
43
)
was
significantly
worse
than
that
of
the
patients
with
a
negative
PM
treated
without
additional
resection
(
n
=
149
;
P
=
0
.
031
)
and
did
not
significantly
differ
from
that
of
the
patients
with
a
positive
PM
(
n
=
32
;
P
=
0
.
215
)
.
A
multivariate
analysis
demonstrated
that
the
carbohydrate
antigen
19
-
9
(
CA
1
9
-
9
)
level
(
<
64
or
≥
64
)
,
combined
vascular
resection
,
pN
,
pM
,
the
histological
grade
,
perineural
invasion
,
liver
invasion
,
and
R
status
were
independent
prognostic
factors
.
Only
in
the
subgroups
of
CA
1
9
-
9
<
64
and
pM
0
,
the
survival
of
the
patients
with
a
negative
PM
treated
with
additional
resection
was
significantly
better
than
that
of
the
patients
with
a
positive
PM
(
P
=
0
.
019
and
P
=
0
.
021
,
respectively
)
.
Additional
resection
of
the
invasive
cancer
-
positive
PMs
may
be
warranted
only
in
limited
patients
with
a
lower
level
of
CA
1
9
-
9
and
no
distant
metastatic
disease
.
Diseases
Validation
Diseases presenting
"cancer"
symptom
achondroplasia
acute rheumatic fever
adrenal incidentaloma
alpha-thalassemia
benign recurrent intrahepatic cholestasis
cadasil
canavan disease
carcinoma of the gallbladder
cholangiocarcinoma
coats disease
congenital adrenal hyperplasia
congenital diaphragmatic hernia
cowden syndrome
cushing syndrome
cutaneous mastocytosis
dedifferentiated liposarcoma
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
erdheim-chester disease
erythropoietic protoporphyria
esophageal adenocarcinoma
esophageal carcinoma
esophageal squamous cell carcinoma
familial hypocalciuric hypercalcemia
familial mediterranean fever
gm1 gangliosidosis
heparin-induced thrombocytopenia
hereditary cerebral hemorrhage with amyloidosis
hirschsprung disease
hodgkin lymphoma, classical
inclusion body myositis
junctional epidermolysis bullosa
kabuki syndrome
kallmann syndrome
kindler syndrome
lamellar ichthyosis
liposarcoma
locked-in syndrome
lymphangioleiomyomatosis
monosomy 21
neuralgic amyotrophy
oculocutaneous albinism
oligodontia
oral submucous fibrosis
papillon-lefèvre syndrome
pendred syndrome
pleomorphic liposarcoma
primary effusion lymphoma
proteus syndrome
pyomyositis
pyruvate dehydrogenase deficiency
severe combined immunodeficiency
sneddon syndrome
systemic capillary leak syndrome
triple a syndrome
von hippel-lindau disease
waldenström macroglobulinemia
well-differentiated liposarcoma
werner syndrome
wiskott-aldrich syndrome
wolf-hirschhorn syndrome
x-linked adrenoleukodystrophy
This symptom has already been validated
