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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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| Published in: | World journal of surgery 2012-09, Vol.36 (9), p.2179-2186 |
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| container_issue | 9 |
| container_start_page | 2179 |
| container_title | World journal of surgery |
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| creator | Ruys, Anthony T. van Haelst, Steven Busch, Olivier R. Rauws, Erik A. Gouma, Dirk J. van Gulik, Thomas M. |
| description | 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
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| doi_str_mv | 10.1007/s00268-012-1638-5 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3414707</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1033153529</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5209-83c22bc9ed2695938e654cd85c62c67836b9242cdcda4758628cc76e3ccfbe5d3</originalsourceid><addsrcrecordid>eNqFkV9rFDEUxYModlv9AL7IgC--jCY3_2ZeBLvYVlmwUBcfQ-ZOdpsyM6nJzEq_vRmmliqIT0nI75ycm0PIK0bfMUr1-0QpqKqkDEqmeFXKJ2TFBIcSOPCnZEW5EnnP-BE5TumGUqYVVc_JEYBUtRZqRbabMOzL0cW-uJriwR9sV_ihuPCdjcX6OnR22PuANqIfQm8L26VQXIaUfNO5mdwO0SWHo53Pl3b0bhjTC_Jsl0n38n49IduzT9_WF-Xm6_nn9cdNiRJoXVYcARqsXQuqljWvnJIC20qiAlS64qqpQQC22FqhZaWgQtTKccRd42TLT8iHxfd2anrXYn472s7cRt_beGeC9ebPm8Ffm304GC6Y0FRng7f3BjH8mFwaTe8Tui6P7cKUDKOcM8kl1Bl98xd6E6Y45PFmCrSeE2aKLRTG_EnR7R7CMGrm0sxSmsmlmbk0I7Pm9eMpHhS_W8pAvQA_fefu_u9ovn-5Oj2jioo5NizalGXD3sXHsf-V6BdaRLO2</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1032774758</pqid></control><display><type>article</type><title>Long-term Survival in Hilar Cholangiocarcinoma also Possible in Unresectable Patients</title><source>Springer Nature</source><creator>Ruys, Anthony T. ; van Haelst, Steven ; Busch, Olivier R. ; Rauws, Erik A. ; Gouma, Dirk J. ; van Gulik, Thomas M.</creator><creatorcontrib>Ruys, Anthony T. ; van Haelst, Steven ; Busch, Olivier R. ; Rauws, Erik A. ; Gouma, Dirk J. ; van Gulik, Thomas M.</creatorcontrib><description>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
< 0.001). Of the 160 unresectable patients, 17 (10 %) survived longer than 3 years.
Conclusion
Of the patients presenting with HCCA in our center, 26 % proved resectable. The 7 % long-term survival rate of unresectable patients is remarkable and emphasizes the indolent growth of some of these tumors. Patients with metastases had a much worse prognosis with a median of 4 months.</description><identifier>ISSN: 0364-2313</identifier><identifier>EISSN: 1432-2323</identifier><identifier>DOI: 10.1007/s00268-012-1638-5</identifier><identifier>PMID: 22569746</identifier><language>eng</language><publisher>New York: Springer-Verlag</publisher><subject>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</subject><ispartof>World journal of surgery, 2012-09, Vol.36 (9), p.2179-2186</ispartof><rights>The Author(s) 2012</rights><rights>2012 The Author(s)</rights><rights>Société Internationale de Chirurgie 2012</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5209-83c22bc9ed2695938e654cd85c62c67836b9242cdcda4758628cc76e3ccfbe5d3</citedby><cites>FETCH-LOGICAL-c5209-83c22bc9ed2695938e654cd85c62c67836b9242cdcda4758628cc76e3ccfbe5d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22569746$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ruys, Anthony T.</creatorcontrib><creatorcontrib>van Haelst, Steven</creatorcontrib><creatorcontrib>Busch, Olivier R.</creatorcontrib><creatorcontrib>Rauws, Erik A.</creatorcontrib><creatorcontrib>Gouma, Dirk J.</creatorcontrib><creatorcontrib>van Gulik, Thomas M.</creatorcontrib><title>Long-term Survival in Hilar Cholangiocarcinoma also Possible in Unresectable Patients</title><title>World journal of surgery</title><addtitle>World J Surg</addtitle><addtitle>World J Surg</addtitle><description>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
< 0.001). Of the 160 unresectable patients, 17 (10 %) survived longer than 3 years.
Conclusion
Of the patients presenting with HCCA in our center, 26 % proved resectable. The 7 % long-term survival rate of unresectable patients is remarkable and emphasizes the indolent growth of some of these tumors. Patients with metastases had a much worse prognosis with a median of 4 months.</description><subject>Abdominal Surgery</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Bile Duct Neoplasms - mortality</subject><subject>Bile Duct Neoplasms - pathology</subject><subject>Bile Ducts, Intrahepatic</subject><subject>Biliary Drainage</subject><subject>Cardiac Surgery</subject><subject>Cholangiocarcinoma - mortality</subject><subject>Cholangiocarcinoma - pathology</subject><subject>Cohort Studies</subject><subject>Extrahepatic Metastasis</subject><subject>Female</subject><subject>Future Remnant Liver</subject><subject>General Surgery</subject><subject>Hilar Cholangiocarcinoma</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Portal Vein Embolization</subject><subject>Prognosis</subject><subject>Surgery</subject><subject>Survival Analysis</subject><subject>Thoracic Surgery</subject><subject>Vascular Surgery</subject><issn>0364-2313</issn><issn>1432-2323</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><recordid>eNqFkV9rFDEUxYModlv9AL7IgC--jCY3_2ZeBLvYVlmwUBcfQ-ZOdpsyM6nJzEq_vRmmliqIT0nI75ycm0PIK0bfMUr1-0QpqKqkDEqmeFXKJ2TFBIcSOPCnZEW5EnnP-BE5TumGUqYVVc_JEYBUtRZqRbabMOzL0cW-uJriwR9sV_ihuPCdjcX6OnR22PuANqIfQm8L26VQXIaUfNO5mdwO0SWHo53Pl3b0bhjTC_Jsl0n38n49IduzT9_WF-Xm6_nn9cdNiRJoXVYcARqsXQuqljWvnJIC20qiAlS64qqpQQC22FqhZaWgQtTKccRd42TLT8iHxfd2anrXYn472s7cRt_beGeC9ebPm8Ffm304GC6Y0FRng7f3BjH8mFwaTe8Tui6P7cKUDKOcM8kl1Bl98xd6E6Y45PFmCrSeE2aKLRTG_EnR7R7CMGrm0sxSmsmlmbk0I7Pm9eMpHhS_W8pAvQA_fefu_u9ovn-5Oj2jioo5NizalGXD3sXHsf-V6BdaRLO2</recordid><startdate>201209</startdate><enddate>201209</enddate><creator>Ruys, Anthony T.</creator><creator>van Haelst, Steven</creator><creator>Busch, Olivier R.</creator><creator>Rauws, Erik A.</creator><creator>Gouma, Dirk J.</creator><creator>van Gulik, Thomas M.</creator><general>Springer-Verlag</general><general>Springer‐Verlag</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201209</creationdate><title>Long-term Survival in Hilar Cholangiocarcinoma also Possible in Unresectable Patients</title><author>Ruys, Anthony T. ; van Haelst, Steven ; Busch, Olivier R. ; Rauws, Erik A. ; Gouma, Dirk J. ; van Gulik, Thomas M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5209-83c22bc9ed2695938e654cd85c62c67836b9242cdcda4758628cc76e3ccfbe5d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Abdominal Surgery</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Bile Duct Neoplasms - mortality</topic><topic>Bile Duct Neoplasms - pathology</topic><topic>Bile Ducts, Intrahepatic</topic><topic>Biliary Drainage</topic><topic>Cardiac Surgery</topic><topic>Cholangiocarcinoma - mortality</topic><topic>Cholangiocarcinoma - pathology</topic><topic>Cohort Studies</topic><topic>Extrahepatic Metastasis</topic><topic>Female</topic><topic>Future Remnant Liver</topic><topic>General Surgery</topic><topic>Hilar Cholangiocarcinoma</topic><topic>Humans</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Portal Vein Embolization</topic><topic>Prognosis</topic><topic>Surgery</topic><topic>Survival Analysis</topic><topic>Thoracic Surgery</topic><topic>Vascular Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ruys, Anthony T.</creatorcontrib><creatorcontrib>van Haelst, Steven</creatorcontrib><creatorcontrib>Busch, Olivier R.</creatorcontrib><creatorcontrib>Rauws, Erik A.</creatorcontrib><creatorcontrib>Gouma, Dirk J.</creatorcontrib><creatorcontrib>van Gulik, Thomas M.</creatorcontrib><collection>SpringerOpen(OpenAccess)</collection><collection>Wiley Online Library Open Access</collection><collection>Wiley-Blackwell Free Backfiles(OpenAccess)</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Immunology Abstracts</collection><collection>ProQuest Health and Medical</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>World journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ruys, Anthony T.</au><au>van Haelst, Steven</au><au>Busch, Olivier R.</au><au>Rauws, Erik A.</au><au>Gouma, Dirk J.</au><au>van Gulik, Thomas M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-term Survival in Hilar Cholangiocarcinoma also Possible in Unresectable Patients</atitle><jtitle>World journal of surgery</jtitle><stitle>World J Surg</stitle><addtitle>World J Surg</addtitle><date>2012-09</date><risdate>2012</risdate><volume>36</volume><issue>9</issue><spage>2179</spage><epage>2186</epage><pages>2179-2186</pages><issn>0364-2313</issn><eissn>1432-2323</eissn><abstract>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
< 0.001). Of the 160 unresectable patients, 17 (10 %) survived longer than 3 years.
Conclusion
Of the patients presenting with HCCA in our center, 26 % proved resectable. The 7 % long-term survival rate of unresectable patients is remarkable and emphasizes the indolent growth of some of these tumors. Patients with metastases had a much worse prognosis with a median of 4 months.</abstract><cop>New York</cop><pub>Springer-Verlag</pub><pmid>22569746</pmid><doi>10.1007/s00268-012-1638-5</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| source | Springer Nature |
| 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 |
| title | Long-term Survival in Hilar Cholangiocarcinoma also Possible in Unresectable Patients |
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