Surgical and combined treatment of patients with Klatzkin's tumor

Surgery as being a preferential method of treatment of patients with cholangiocarcinoma is associated with high complications and mortality levels while demonstrating poor long-term outcomes. Optimization of preoperative management and improvement of the results of surgical treatment for patients wi...

Full description

Saved in:
Bibliographic Details
Published inHirurgija (Moskva) no. 10; p. 33
Main Authors Patiutko, Iu I, Poliakov, A N, Kotel'nikov, A G, Sagaĭdak, I V, Gakhramanov, A D, Moroz, E A, Chaĭ, I
Format Journal Article
LanguageEnglish
Published Russia (Federation) 2014
Subjects
Bile Duct Neoplasms - mortality
Bile Duct Neoplasms - pathology
Bile Duct Neoplasms - therapy
Bile Ducts, Extrahepatic - pathology
Bile Ducts, Extrahepatic - surgery
Chemotherapy, Adjuvant - methods
Cholangiocarcinoma - mortality
Cholangiocarcinoma - pathology
Cholangiocarcinoma - therapy
Female
Hepatectomy - methods
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Moscow - epidemiology
Neoplasm Staging
Operative Time
Photochemotherapy - methods
Portal Vein - pathology
Portal Vein - surgery
Postoperative Complications - classification
Postoperative Complications - epidemiology
Prognosis
Radiotherapy, Adjuvant - methods
Recurrence
Retrospective Studies
Treatment Outcome
Moscow
Online AccessGet more information

Cover

More Information
Summary:Surgery as being a preferential method of treatment of patients with cholangiocarcinoma is associated with high complications and mortality levels while demonstrating poor long-term outcomes. Optimization of preoperative management and improvement of the results of surgical treatment for patients with proximal extrahepatic bile duct carcinoma. From January 1998 to December 2013 surgical treatment was performed in 36 patients (19 males, 17 females) with Klatzkin's tumor, from whom 10 patients obtained postoperative chemotherapy. Bismuth-Corlette type III-IV tumor stage was determined in 30 (83.3%) patients. Portal vein resection was performed in 13 (36.1%) patients. 27 (75.5%) patients underwent R0 resection. Postoperative mortality rate consisted 16.7%, complications were revealed in 87.1% of cases. 6 (16.7%) patients required additional surgery and interventional procedures were performed in other 20 (55.5%) patients to fix postoperative complications. Overall 5-year survival rate in R0-resection group was 40.1%, median - 29 months. In postoperative chemotherapy group overall 3-year survival rate was 66.7% which was twice higher than in surgery group but the difference was not statistically significant (p=0.35). The improvement of short-term outcomes of surgical treatment for patients with Klatzkin's tumor requires optimization of preoperative management and detailed adherence of surgical techniques. Combination of surgery with postoperative chemotherapy showed the trend to improvement of overall survival.
ISSN:0023-1207