SEARCH

SEARCH BY CITATION

Keywords:

  • peri-hilar cholangiocarcinoma;
  • resection;
  • endoscopic management;
  • overall survival

Abstract

Background and Objectives

Patients with peri-hilar cholangiocarcinoma who undergo R1 resection with curative intent will have an improved survival compared to patients who were not resected.

Methods

Review of a prospective hepatobiliary database identified 130 patients. Survival was compared using the log-rank test.

Results

Seventy-nine patients (61%) were resected while 51 (49%) patients were not. Forty-two patients (54%) had an R0 resection. There was no difference in mean age (69 vs. 67; P = 0.8), BMI (27.8 vs. 27.9; P = 1.0), gender (73% vs. 43% male; P = 0.1), presence of jaundice (77% vs. 64%; P = 0.5), vascular involvement on pre operative imaging (77% vs. 64%; P = 0.5), stent (73.1% vs. 64.3%; P = 0.72), and lobar atrophy (27% vs. 7%, P = 0.2) in the resected versus non-resected patients. All patients underwent chemotherapy and/or radiation therapy. After a median follow up of 35.6 months the median OSl for all peri-hilar patients was 16.2 months (95% CI = 11.2–23.4). The median OS for resected patients was 18.9 months (95% CI = 12.5–24.7) versus 5.0 months (95% CI = 0–6.9) for patients not resected (P < 0.001). The only pre-operative predictor of OS was resection (P = 0.041). Vascular invasion, lobar atrophy, and stent placement were not statistically significant predictors.

Conclusion

Overall survival is improved in patients undergoing R1 resection and multi-modality therapy compared to patients not resected. J. Surg. Oncol. 2012; 105:91–96. © 2011 Wiley Periodicals, Inc.