Long-term Survival in Hilar Cholangiocarcinoma also Possible in Unresectable Patients

Background Radical resection remains the only curative treatment for hilar cholangiocarcinoma (HCCA). Only a limited proportion of patients, however, are eligible for resection. The survival and prognostic factors of these patients are largely unknown. The aim of this study was to evaluate survival...

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Bibliographic Details
Published in:World journal of surgery 2012-09, Vol.36 (9), p.2179-2186
Main Authors: Ruys, Anthony T., van Haelst, Steven, Busch, Olivier R., Rauws, Erik A., Gouma, Dirk J., van Gulik, Thomas M.
Format: Article
Language:English
Subjects:
Abdominal Surgery
Adult
Aged
Aged, 80 and over
Bile Duct Neoplasms - mortality
Bile Duct Neoplasms - pathology
Bile Ducts, Intrahepatic
Biliary Drainage
Cardiac Surgery
Cholangiocarcinoma - mortality
Cholangiocarcinoma - pathology
Cohort Studies
Extrahepatic Metastasis
Female
Future Remnant Liver
General Surgery
Hilar Cholangiocarcinoma
Humans
Male
Medicine
Medicine & Public Health
Middle Aged
Portal Vein Embolization
Prognosis
Surgery
Survival Analysis
Thoracic Surgery
Vascular Surgery
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Summary:Background Radical resection remains the only curative treatment for hilar cholangiocarcinoma (HCCA). Only a limited proportion of patients, however, are eligible for resection. The survival and prognostic factors of these patients are largely unknown. The aim of this study was to evaluate survival and prognostic factors in unresectable patients presenting with HCCA. Methods We performed a cohort study of the denominator of HCCA patients seen in a tertiary referral center between March 2003 and March 2009. Demographics, treatment, pathology results, and survival were analyzed. Results A total of 217 patients with suspected HCCA were identified. Ninety-five patients (40 %) underwent laparotomy, and in 57 (63 %) of these patients resection was performed. Overall median and 5-year survival of resected patients were 37 months and 43 %, respectively, as compared to 13 months and 7 % in unresectable patients. In unresectable patients, median survival was better in patients with locally advanced disease (16 months) as compared to patients with hepatic and extrahepatic metastases (5 and 3 months, p  
ISSN:0364-2313
1432-2323
DOI:10.1007/s00268-012-1638-5