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Annals of Surgical Oncology

, Volume 26, Issue 2, pp 611–618 | Cite as

Actual 5-Year Survivors After Surgical Resection of Hilar Cholangiocarcinoma

  • Thuy B. Tran
  • Cecilia G. Ethun
  • Timothy M. Pawlik
  • Carl Schmidt
  • Eliza W. Beal
  • Ryan C. Fields
  • Bradley Krasnick
  • Sharon M. Weber
  • Ahmed Salem
  • Robert C. G. Martin
  • Charles R. Scoggins
  • Perry Shen
  • Harveshp D. Mogal
  • Kamran Idrees
  • Chelsea A. Isom
  • Ioannis Hatzaras
  • Rivfka Shenoy
  • Shishir K. Maithel
  • George A. PoultsidesEmail author
Hepatobiliary Tumors

Abstract

Background

The prevalence and characteristics of actual 5-year survivors after surgical treatment of hilar cholangiocarcinoma (HC) have not been described previously.

Methods

Patients who underwent resection for HC from 2000 to 2015 were analyzed through a multi-institutional registry from 10 U.S. academic medical centers. The clinicopathologic characteristics and both the perioperative and long-term outcomes for actual 5-year survivors were compared with those for non-survivors (patients who died within 5 years after surgery). Patients alive at last encounter who had a follow-up period shorter than 5 years were excluded from the study.

Results

The study identified 257 patients with HC who underwent curative-intent resection with an actuarial 5-year survival of 19%. Of 194 patients with a follow-up period longer than 5 years, 23 (12%) were 5-year survivors. Compared with non-survivors, the 5-year survivors had a lower median pretreatment CA 19-9 level (116 vs. 34 U/L; P = 0.008) and a lower rate of lymph node involvement (42% vs. 15%; P = 0.027) and R1 margins (39% vs. 17%; P = 0.042). However, the sole presence of these factors did not preclude a 5-year survival after surgery. The frequencies of bile duct resection alone, major hepatectomy, caudate lobe resection, portal vein or hepatic artery resection, preoperative biliary sepsis, intraoperative blood transfusion, serious postoperative complications, and receipt of adjuvant chemotherapy were comparable between the two groups.

Conclusions

One in eight patients with HC reaches the 5-year survival milestone after resection. A 5-year survival can be achieved even in the presence of traditionally unfavorable clinicopathologic factors (elevated CA 19-9, nodal metastasis, and R1 margins).

Notes

Disclosure

There are no conflicts of interest.

Supplementary material

10434_2018_7075_MOESM1_ESM.docx (13 kb)
Supplementary material 1 (DOCX 12 kb)

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Copyright information

© Society of Surgical Oncology 2018

Authors and Affiliations

  • Thuy B. Tran
    • 1
  • Cecilia G. Ethun
    • 2
  • Timothy M. Pawlik
    • 3
    • 4
  • Carl Schmidt
    • 4
  • Eliza W. Beal
    • 4
  • Ryan C. Fields
    • 5
  • Bradley Krasnick
    • 5
  • Sharon M. Weber
    • 6
  • Ahmed Salem
    • 6
  • Robert C. G. Martin
    • 7
  • Charles R. Scoggins
    • 7
  • Perry Shen
    • 8
  • Harveshp D. Mogal
    • 8
  • Kamran Idrees
    • 9
  • Chelsea A. Isom
    • 9
  • Ioannis Hatzaras
    • 10
  • Rivfka Shenoy
    • 10
  • Shishir K. Maithel
    • 2
  • George A. Poultsides
    • 1
    Email author
  1. 1.Department of SurgeryStanford UniversityStanfordUSA
  2. 2.Department of Surgery, Winship Cancer InstituteEmory UniversityAtlantaUSA
  3. 3.Department of SurgeryThe Johns Hopkins HospitalBaltimoreUSA
  4. 4.Department of SurgeryThe Ohio State UniversityColumbusUSA
  5. 5.Department of SurgeryWashington University School of MedicineSt LouisUSA
  6. 6.Department of SurgeryUniversity of Wisconsin School of Medicine and Public HealthMadisonUSA
  7. 7.Department of SurgeryUniversity of LouisvilleLouisvilleUSA
  8. 8.Department of SurgeryWake Forest UniversityWinston-SalemUSA
  9. 9.Department of SurgeryVanderbilt University Medical CenterNashvilleUSA
  10. 10.Department of SurgeryNew York UniversityNew YorkUSA

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