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Surgical Management and Prognostic Factors of Hilar Cholangiocarcinoma: Experience with 115 Cases in China

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Hilar cholangiocarcinoma (or Klatskin tumor) is a rare condition, accounting for less than 1% of all cancers. This study was designed to assess the surgical and postsurgical management of affected patients, including the postoperative chemotherapy, and an analysis to determine prognostic factors for postoperative morbidity and mortality.

Methods

A retrospective review of 115 consecutive cases treated with resection between January 1990 and January 2004 at a single university medical center in southern China was carried out. Clinicopathological data were analyzed and univariate and multivariate analyses against outcome was employed to determine the prognostic significance of a variety of factors including excision margin characteristics, status of metastases, tumor type, histological differentiation, lymph node characteristics, and postoperative therapy.

Results

Median survival time of patients treated with resection and anastomosis with postoperative chemotherapy was 41 months compared with 36 months for patients who did not receive chemotherapy postoperatively. Factors correlating with shorter survival were positive excision margin, metastasis, adenoacanthoma-type tumor, poor or unknown histological differentiation, and positive lymph nodes. In addition, postoperative chemotherapy improved survival. Patients treated with chemotherapy postoperatively had a survival of 43.15 ± 21.02 months, which was significantly longer than the survival of patients who received no postoperatively chemotherapy (36.97 ± 15.99 months; P < 0.05).

Conclusion

Resection with anastomosis and postoperative chemotherapy results in longer survival time compared with no chemotherapy postoperatively. Positive excision margins, metastases, adenoacanthoma-type tumor, poor or unknown histological differentiation, and positive lymph nodes correlate with shorter survival.

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Acknowledgements

This research was supported by Year 2006 Guangdong Province Sci-Tech Program (Project code: 20062270100, Type: major sci-tech items), and by Year 2005 Guangdong Province Medical Science Technology Research Fund (Project code: WSTJJ20041020440102197011040617). In particular, we thank the staff of Guangdong Provincial People’s Hospital for all their contributions.

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Authors and Affiliations

  1. Hepatobiliary Department, Guangdong Provincial People’s Hospital, Guangzhou, No. 106, Zhongshan 2 Road, Guangzhou, 510080, PR China

    Liu Yubin PhD, Jian Zhixiang MM, Ou Jinrui BA, Liu Zixian BA, Zheng Jianghua BA, Lin Ye MD & Jin Haosheng MD

  2. Hepatobiliary Department, Zhujiang Hospital, Southern Medical University, Guangzhou, PR China

    Fang Chihua PhD & Lu Chaomin PhD

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  1. Liu Yubin PhD
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  2. Fang Chihua PhD
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  3. Jian Zhixiang MM
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  4. Ou Jinrui BA
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  5. Liu Zixian BA
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  6. Zheng Jianghua BA
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  7. Lin Ye MD
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  8. Jin Haosheng MD
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  9. Lu Chaomin PhD
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Corresponding author

Correspondence to Jian Zhixiang MM.

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Yubin, L., Chihua, F., Zhixiang, J. et al. Surgical Management and Prognostic Factors of Hilar Cholangiocarcinoma: Experience with 115 Cases in China. Ann Surg Oncol 15, 2113–2119 (2008). https://doi.org/10.1245/s10434-008-9932-z

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  • DOI: https://doi.org/10.1245/s10434-008-9932-z

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