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01-05-2012

Role of Caudate Lobectomy in Type III_A and III_B Hilar Cholangiocarcinoma: A 15-year Experience in a Tertiary Institution

Authors: Alfred Wei-Chieh Kow, Choi Dong Wook, Sun Choon Song, Woo Seok Kim, Min Jung Kim, Hyo Jun Park, Jin Soek Heo, Seong Ho Choi

Published in: World Journal of Surgery | Issue 5/2012

Abstract

Background

Concomitant liver resection for type III hilar cholangiocarcinoma could improve the R0 resection rate and long-term outcome. In the present study, we examine the specific role of caudate lobectomy in liver resection for type III_A and III_B hilar cholangiocarcinoma and the prognostic factors for survival in this group of patients.

Methods

We reviewed all patients with type III_A and III_B hilar cholangiocarcinoma who underwent liver resection in Samsung Medical Center from January 1995 to July 2010. Patients were divided into those with and without caudate lobectomy (CL). The log rank test and Cox regression analysis were employed to investigate for prognostic factors of survival.

Results

There were 127 patients in this cohort, 57 without CL (44.9%) and 70 with CL (55.1%). The demographics and symptoms of presentation were comparable. The median preoperative bilirubin level was significantly higher in the group undergoing CL (p = 0.017). Patients with CL had a significantly better overall survival (OS) (CL: 64.0 months vs without CL: 34.6 months) (p = 0.010) and disease-free survival (DFS) (CL: 40.5 months vs without CL: 27.0 months) (p = 0.031). Multivariate analysis showed that presence of symptoms (p = 0.025) and positive lymph node (LN) metastasis (p < 0.001) were negative prognostic factors for OS. Furthermore, multivariate analysis for DFS found that caudate lobectomy (p = 0.016) and positive LN metastasis (p = 0.001) were positive and negative prognostic factors, respectively.

Conclusions

Caudate lobectomy contributed to improvement of DFS and OS in type III hilar cholangiocarcinoma. Other prognostic factors include positive LN metastasis and presence of symptoms.

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Title: Role of Caudate Lobectomy in Type IIIA and IIIB Hilar Cholangiocarcinoma: A 15-year Experience in a Tertiary Institution
Authors: Alfred Wei-Chieh Kow
Choi Dong Wook
Sun Choon Song
Woo Seok Kim
Min Jung Kim
Hyo Jun Park
Jin Soek Heo
Seong Ho Choi
Publication date: 01-05-2012
Publisher: Springer-Verlag
Published in: World Journal of Surgery / Issue 5/2012
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-012-1497-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Role of Caudate Lobectomy in Type III_A and III_B Hilar Cholangiocarcinoma: A 15-year Experience in a Tertiary Institution

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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