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Outcome of Surgical Treatment of Hilar Cholangiocarcinoma

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

To evaluate surgical results and the effect of adjuvant chemotherapy in cases of hilar cholangiocarcinoma, we retrospectively analyzed 27 consecutive patients who underwent surgical resection (eight bile duct resections, 18 bile duct resections plus hepatectomy, one hepatopancreaticoduodenectomy). There was no operative mortality, and the morbidity was 37%. Curative resection (R0 resection) was achieved in 20 (74%) patients. Overall survival at 3 and 5 years was 44% and 27%, significantly higher than that of 47 patients who did not undergo resection (3.5% and 0% at 3 and 5 years, p < 0.0001). Survival of patients with positive margins (R1/2 resection) was poor; there were no 5-year survivors. However, survival was better than that of patients who did not undergo resection (median survival: 22 vs 9 months, p = 0.0007). Univariate analysis identified lymph node metastasis as a negative prognostic factor (p = 0.043). Median survival of patients who underwent adjuvant chemotherapy was significantly longer than that of patients who did not (42 vs. 22 months, p = 0.0428). Resection should be considered as the first option for hilar cholangiocarcinoma. There appears to be a survival advantage even in patients with cancer-positive margins. Adjuvant chemotherapy may increase long-term survival.

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Authors and Affiliations

  1. Department of Surgical Oncology and Regulation of Organ Function, Miyazaki University School of Medicine, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan

    Kazuhiro Otani, Kazuo Chijiiwa, Masahiro Kai, Jiro Ohuchida, Motoaki Nagano, Kazuyo Tsuchiya & Kazuhiro Kondo

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  1. Kazuhiro Otani
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  2. Kazuo Chijiiwa
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  3. Masahiro Kai
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  4. Jiro Ohuchida
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  6. Kazuyo Tsuchiya
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  7. Kazuhiro Kondo
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Correspondence to Kazuo Chijiiwa.

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Otani, K., Chijiiwa, K., Kai, M. et al. Outcome of Surgical Treatment of Hilar Cholangiocarcinoma. J Gastrointest Surg 12, 1033–1040 (2008). https://doi.org/10.1007/s11605-007-0453-z

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  • DOI: https://doi.org/10.1007/s11605-007-0453-z

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