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World Journal of Surgery

, Volume 40, Issue 10, pp 2451–2459 | Cite as

Actual Long-Term Survival Outcome of 403 Consecutive Patients with Hilar Cholangiocarcinoma

  • Mee Joo Kang
  • Jin-Young Jang
  • Jihoon Chang
  • Yong Chan Shin
  • Dooho Lee
  • Hong Beom Kim
  • Sun-Whe KimEmail author
Original Scientific Report

Abstract

Background

Despite aggressive surgical resection, prognosis of patients with hilar cholangiocarcinoma is still unsatisfactory. There were limited data about actual long-term survival outcome. This study was designed to explore actual long-term survival outcome of hilar cholangiocarcinoma after surgical treatment, and to investigate the characteristics of patients with actual long-term survival.

Methods

The study cohort consisted of 403 consecutive patients with at least 5-year follow-up after surgical treatment for hilar cholangiocarcinoma at Seoul National University Hospital between 1991 and 2010. Prognostic factors were analyzed with Cox proportional hazard models, and the effect of adjuvant treatment was evaluated by propensity score analysis.

Results

Of all patients, R0 resection rate was 41.2 and 63.8 % among intended curative resection. Adjuvant therapy was performed in 48.8 % after curative surgery. Actual 5-year overall survival (OS) rate was 18.9, and 30.1 % after R0 resection. Actual 5-year disease-free survival rate was 25.8 % after resection. Adjuvant treatment improved prognosis in patients with positive metastatic lymph nodes (median OS 21.9 vs. 11.5 months, p = 0.003). Overall recurrence rate was 55.0 %, and distant metastasis (39.7 %) was more frequent than loco-regional recurrence (20.8 %). Lymph node metastasis (p = 0.021) and poor histologic grade (p < 0.001) were independent prognostic factors after curative resection. Patients who survived more than 5 years had less lymph node metastasis (p = 0.025), poor histologic differentiation (p = 0.010), R2 resection (p = 0.040), and recurrence (p < 0.001).

Conclusion

Actual 5-year OS rate after R0 resection of hilar cholangiocarcinoma is 30.1 %. Adjuvant treatment could be beneficial in patients with lymph node metastasis.

Keywords

Overall Survival Propensity Score National Comprehensive Cancer Network Hilar Cholangiocarcinoma Bile Duct Cancer 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments

This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI14C2640).

Compliance with ethical standards

Competing interests

The authors disclose no conflicts.

Supplementary material

268_2016_3551_MOESM1_ESM.docx (22 kb)
Supplementary material 1 (DOCX 21 kb)

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Copyright information

© Société Internationale de Chirurgie 2016

Authors and Affiliations

  • Mee Joo Kang
    • 1
  • Jin-Young Jang
    • 1
  • Jihoon Chang
    • 1
  • Yong Chan Shin
    • 1
  • Dooho Lee
    • 1
  • Hong Beom Kim
    • 1
  • Sun-Whe Kim
    • 1
    Email author
  1. 1.Department of Surgery and Cancer Research InstituteSeoul National University College of MedicineSeoulSouth Korea

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