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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 3/2021

Open Access 01-03-2021 | Liver Transplantation | Hepatobiliary Tumors

Eligibility for Liver Transplantation in Patients with Perihilar Cholangiocarcinoma

Authors: Jaynee J. A. Vugts, MD, Marcia P. Gaspersz, MD, Eva Roos, MD, Lotte C. Franken, MD, Pim B. Olthof, MD, PhD, Robert J. S. Coelen, MD, PhD, Jeroen L. A. van Vugt, MD, PhD, Tim A. Labeur, MD, Lieke Brouwer, MD, PhD, Marc G. H. Besselink, MD, PhD, Jan N. M. IJzermans, MD, PhD, Sarwa Darwish Murad, MD, PhD, Thomas M. van Gulik, MD, PhD, Jeroen de Jonge, MD, PhD, Wojciech G. Polak, MD, PhD, Olivier R. C. Busch, MD, Joris L. Erdmann, MD, PhD, Bas Groot Koerkamp, MD, PhD, Stefan Buettner, PhD

Published in: Annals of Surgical Oncology | Issue 3/2021

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Abstract

Background

Liver transplantation (LT) has been performed in a select group of patients presenting with unresectable or primary sclerosing cholangitis (PSC)-associated perihilar cholangiocarcinoma (pCCA) in the Mayo Clinic with a reported 5-year overall survival (OS) of 53% on intention-to-treat analysis. The objective of this study was to estimate eligibility for LT in a cohort of pCCA patients in two tertiary referral centers.

Methods

Patients diagnosed with pCCA between 2002 and 2014 were included from two tertiary referral centers in the Netherlands. The selection criteria used by the Mayo Clinic were retrospectively applied to determine the proportion of patients that would have been eligible for LT.

Results

A total of 732 consecutive patients with pCCA were identified, of whom 24 (4%) had PSC-associated pCCA. Overall, 154 patients had resectable disease on imaging and 335 patients were ineligible for LT because of lymph node or distant metastases. An age limit of 70 years led to the exclusion of 50 patients who would otherwise be eligible for LT. After applying the Mayo Clinic criteria, only 34 patients (5%) were potentially eligible for LT. Median survival from diagnosis for these 34 patients was 13 months (95% CI 3–23).

Conclusion

Only 5% of all patients presenting with pCCA were potentially eligible for LT under the Mayo criteria. Without transplantation, a median OS of about 1 year was observed.
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Metadata
Title
Eligibility for Liver Transplantation in Patients with Perihilar Cholangiocarcinoma
Authors
Jaynee J. A. Vugts, MD
Marcia P. Gaspersz, MD
Eva Roos, MD
Lotte C. Franken, MD
Pim B. Olthof, MD, PhD
Robert J. S. Coelen, MD, PhD
Jeroen L. A. van Vugt, MD, PhD
Tim A. Labeur, MD
Lieke Brouwer, MD, PhD
Marc G. H. Besselink, MD, PhD
Jan N. M. IJzermans, MD, PhD
Sarwa Darwish Murad, MD, PhD
Thomas M. van Gulik, MD, PhD
Jeroen de Jonge, MD, PhD
Wojciech G. Polak, MD, PhD
Olivier R. C. Busch, MD
Joris L. Erdmann, MD, PhD
Bas Groot Koerkamp, MD, PhD
Stefan Buettner, PhD
Publication date
01-03-2021
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 3/2021
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-020-09001-8

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