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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 8/2008

01-08-2008 | Gastrointestinal Oncology

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

Authors: Liu Yubin, PhD, Fang Chihua, PhD, Jian Zhixiang, MM, Ou Jinrui, BA, Liu Zixian, BA, Zheng Jianghua, BA, Lin Ye, MD, Jin Haosheng, MD, Lu Chaomin, PhD

Published in: Annals of Surgical Oncology | Issue 8/2008

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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.
Literature
1.
Vauthey JN, Blumgart LH. Recent advances in the management of cholangiocarcinomas. Semin Liver Dis 1994; 14:109–14PubMedCrossRef
2.
Khan SA, Taylor-Robinson SD, Toledano MB, et al. Changing international trends in mortality rates for liver, biliary and pancreatic tumours. J Hepatol 2002; 37:806–13PubMedCrossRef
3.
4.
5.
Wahab MA, Fathy O, Elgwalby A, et al. Resectability and prognostic factors after resection of hilar carcinonoma. Hepato-Gastroenterology 2006; 53:5–10PubMed
6.
DeOliveira ML, Cunningham SC, Cameron JL, et al. Cholangiocarcinoma: thirty-one-year experience with 564 patients at a single institution. Ann Surg 2007; 245(5):755–62
7.
Witzigmann H, Berr F, Ringel U, et al. Surgical and palliative management and outcome in 184 patients with hilar cholangiocarcinoma: palliative photodynamic therapy plus stenting is comparable to r1/r2 resection. Ann Surg 2006; 244(2):230–9
8.
Dinant S, Gerhards MF, Rauws EA, et al. Improved outcome of resection of hilar cholangiocarcinoma (Klatskin tumor). Ann Surg Oncol 2006; 13(6):872–80
9.
Sagawa N, Kondo S, Morikawa T, et al. Effectiveness of radiation therapy after surgery for hilar cholangiocarcinoma. Surg Today 2005; 35:548–52PubMedCrossRef
10.
Gerhards MF, van Gulik TM, González DG, et al. Results of postoperative radiotherapy for resectable hilar cholangiocarcinoma. World J Surg 2003; 27:173–9PubMed
11.
Bismuth H, Castaing D, Traynor O. Resection or palliation: priority of surgery in the treatment of hilar cancer. World J Surg 1988; 12:39–47PubMedCrossRef
12.
Zervos EE, Osborne D, Goldin SB, et al. Stage does not predict survival after resection of hilar cholangiocarcinomas promoting an aggressive operative approach. Am J Surg 2005; 190:810–5PubMedCrossRef
13.
Hann LE, Greatrex KV, Bach AM, et al. Cholangiocarcinoma at the hepatic hilus: sonographic findings. AJR Am J Roentgenol 1997; 168:985–9PubMed
14.
Hasegawa S, Ikai I, Fujii H, et al. Surgical resection of hilar cholangiocarcinoma: analysis of survival and postoperative complications. World J Surg 2007; 31(6):1256–63
15.
Rea DJ, Munoz-Juarez M, Farnell MB, et al. Major hepatic resection for hilar cholangiocarcinoma: analysis of 46 patients. Arch Surg 2004; 139:514–23; discussion 523–5PubMedCrossRef
16.
Bismuth H, Nakache B, Diamond T. Management strategies in resection for hilar cholangiocarcinoma. Ann Surg 1992; 215:31–8PubMedCrossRef
17.
Li HM, Dou KF, Sun K, et al. Palliative surgery for hilar cholangiocarcinoma. Hepatobiliary Pancreat Dis Int 2003; 2:110–13PubMed
18.
19.
Ohtsuka M, Ito H, Kimura F, et al. Results of surgical treatment for intrahepatic cholangiocarcinoma and clinicopathological factors influencing survival. Br J Surg 2002; 89:1525–31PubMedCrossRef
20.
Ramacciato G, Corigliano N, Mercantini P, et al. Prognostic factors after surgical resection for hilar cholangiocarcinoma. Ann Chir 2006; 131:379–85. Epub 2006 Mar 31. In FrenchPubMedCrossRef
21.
Hanazaki K, Kajikawa S, Shimozawa N, et al. Prognostic factors of intrahepatic cholangiocarcinoma after hepatic resection: univariate and multivariate analysis. Hepatogastroenterology 2002; 49:311–6PubMed
22.
Kawasaki S, Imamura H, Kobayashi A, et al. Results of surgical resection for patients with hilar bile duct cancer: application of extended hepatectomy after biliary drainage and hemihepatic portal vein embolization. Ann Surg 2003; 238:84–92PubMedCrossRef
23.
Ebata T, Nagino M, Kamiya J, et al. Hepatectomy with portal vein resection for hilar cholangiocarcinoma: audit of 52 consecutive cases. Ann Surg 2003; 238:720–7PubMedCrossRef
24.
Zhang BH, Cheng QB, Luo XJ, et al. Surgical therapy for hilar cholangiocarcinoma: analysis of 198 cases. Hepatobiliary Pancreat Dis Int 2006; 5:278–82PubMed
25.
Havlik R, Sbisá E, Tullo A, et al. Results of resection of hilar cholangiocarcinoma with analysis of prognostic factors. Hepato-Gastroenterology 2000; 47:927–31PubMed
26.
Abeler VM, Kjørstad KE. Endometrial adenocarcinoma with squamous cell differentiation. Cancer 1992; 69:488–95PubMedCrossRef
27.
Cavanagh D, Fiorica JV, Hoffman MS, et al. Adenocarcinoma of the endometrium: an institutional review. Cancer Control 1999; 6:354–60PubMed
28.
Frizelle FA, Hobday KS, Batts KP, et al. Adenosquamous and squamous carcinoma of the colon and upper rectum: a clinical and histopathologic study. Dis Colon Rectum 2001;44:341–6PubMedCrossRef
Metadata
Title
Surgical Management and Prognostic Factors of Hilar Cholangiocarcinoma: Experience with 115 Cases in China
Authors
Liu Yubin, PhD
Fang Chihua, PhD
Jian Zhixiang, MM
Ou Jinrui, BA
Liu Zixian, BA
Zheng Jianghua, BA
Lin Ye, MD
Jin Haosheng, MD
Lu Chaomin, PhD
Publication date
01-08-2008
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 8/2008
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-008-9932-z

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