Actual Long-Term Survival Outcome of 403 Consecutive Patients with Hilar Cholangiocarcinoma
- 538 Downloads
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.
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.
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).
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.
KeywordsOverall Survival Propensity Score National Comprehensive Cancer Network Hilar Cholangiocarcinoma Bile Duct Cancer
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
The authors disclose no conflicts.
- 11.Hosokawa I, Shimizu H, Yoshidome H et al (2014) Surgical Strategy for Hilar Cholangiocarcinoma of the Left-Side Predominance: Current Role of Left Trisectionectomy. Ann SurgGoogle Scholar
- 31.Kang MJ, Lee SE, Hwang DW et al (2008) Clinical characteristics of uncinate process carcinoma of the pancreas. Korean J Hepatobiliary Pancreat Surg 12:186–190Google Scholar