Combined vascular resection and analysis of prognostic factors for hilar cholangiocarcinoma

• Published in: Hepatobiliary & pancreatic diseases international Vol. 14; no. 6; pp. 626 - 632
• Main Authors: Wang, Shu-Tong, Shen, Shun-Li, Peng, Bao-Gang, Hua, Yun-Peng, Chen, Bin, Kuang, Ming, Li, Shao-Qiang, He, Qiang, Liang, Li-Jian
• Format: Journal Article
• Language: English
• Published: Singapore Elsevier B.V 01.12.2015; Department of Hepatic Surgery, First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, China
• Subjects: Adult; Aged; Bile Duct Neoplasms - mortality; Bile Duct Neoplasms - pathology; Bile Duct Neoplasms - surgery; Chi-Square Distribution; China; Endocrinology & Metabolism; Female; Gastroenterology and Hepatology; Hepatic Artery - pathology; Hepatic Artery - surgery; hepatic artery resection; hilar cholangiocarcinoma; Humans; Kaplan-Meier Estimate; Klatskin Tumor - mortality; Klatskin Tumor - secondary; Klatskin Tumor - surgery; Lymphatic Metastasis; Magnetic Resonance Imaging; Male; Middle Aged; Multivariate Analysis; Neoplasm Invasiveness; Neoplasm, Residual; Portal Vein - pathology; Portal Vein - surgery; portal vein resection; prognostic factors; Retrospective Studies; Risk Factors; Time Factors; Treatment Outcome; Tumor Burden; Vascular Surgical Procedures - adverse effects; Vascular Surgical Procedures - mortality; China; prognostic factors; portal vein resection; hilar cholangiocarcinoma; hepatic artery resection
• ISSN: 1499-3872
• DOI: 10.1016/S1499-3872(15)60025-X

Background Hilar cholangiocarcinoma (HCCA) is a devastating malignancy arising from the bifurcation of the hepatic duct, whether combined vascular resection benefits HCCA patients is controversial. This study was undertaken to assess the effect of combined vascular resection in HCCA patients and to analyze the prognostic factors. Methods Clinical data of 154 HCCA patients who had been treated from January 2005 to December 2012 were retrospectively analyzed. The patients were divided into three groups based on vascular resection: those without vascular resection; those with portal vein resection alone and those with hepatic artery resection. The survival and complication rates were compared among the three groups. Multivariate analysis was made to determine prognostic factors. Results No significant differences were found in survival and complication rates among the three groups ( P >0.05). Multivariate analysis showed that 3 factors were related to survival: lymph node metastasis, tumor size (>2.5 cm), and positive resection margin. Conclusions Vascular resection improved the survival rate of patients with HCCA involving the hepatic artery or portal vein. Lymph node metastasis, tumor size (>2.5 cm) and positive resection margin were poor prognostic factors in patients with HCCA.