Surgical treatment of hilar cholangiocarcinoma in a new era: comparison among leading Eastern and Western centers, Leeds

• Published in: Journal of hepato-biliary-pancreatic sciences Vol. 17; no. 4; pp. 497 - 504
• Main Authors: Young, Alastair L., Prasad, K. Rajendra, Toogood, Giles J., Lodge, J. Peter A.
• Format: Journal Article
• Language: English
• Published: Japan Springer Japan 01.07.2010; Wiley Subscription Services, Inc
• Subjects: Abdominal Surgery; Adult; Aged; Aged, 80 and over; Bile Duct Neoplasms - diagnosis; Bile Duct Neoplasms - mortality; Bile Duct Neoplasms - surgery; Bile Ducts, Intrahepatic; Cholangiocarcinoma - diagnosis; Cholangiocarcinoma - mortality; Cholangiocarcinoma - surgery; Cholangiopancreatography, Endoscopic Retrograde; Cholangiopancreatography, Magnetic Resonance; Female; Follow-Up Studies; Gastroenterology; Hepatectomy - methods; Hepatology; hilar cholangiocarcinoma; Hospitals, University; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Multivariate analysis; Neoplasm Staging; resection; Retrospective Studies; Surgical Oncology; Survival Rate - trends; Topics; Treatment Outcome; United Kingdom - epidemiology; Hilar cholangiocarcinoma; Resection
• ISSN: 1868-6974; 1868-6982
• DOI: 10.1007/s00534-009-0203-6

Objective Surgery for hilar cholangiocarcinoma (HCCA) remains challenging, with radical procedures thought to offer the best chance of long-term survival. Here we present our data for surgical resection of HCCA for the period 2001–2008. Methods A prospectively maintained database was interrogated to identify all resections. Clinico-pathological data were analyzed and assessed for impact on survival. Results 51 patients were identified. Almost three-quarters required hepatic trisectionectomy. Overall survival was 76% at 1 year, 36% at 3 years and 20% at 5 years. When R0 resection was achieved, the 5-year survival was 40%. Portal vein resection, perineural invasion and T-stage were predictive of overall survival on univariate analysis. Only T-stage remained significant on multivariate analysis. Lymph node status predicted disease-free survival. Conclusion Radical surgery continues to offer the prospect of long-term survival for patients with HCCA. Earlier detection and referral to tertiary centers may allow more patients to have potentially curative surgical resections.