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Am J Surg. 2011 Sep;202(3):310-20. doi: 10.1016/j.amjsurg.2010.08.041.

Improved outcomes after aggressive surgical resection of hilar cholangiocarcinoma: a critical analysis of recurrence and survival.

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  • 1Department of Surgery, Hepatobiliary and Surgical Oncology Unit, University of New South Wales, St. George Hospital, Level 3 Pitney Building, Short St., Kogarah, New South Wales 2217, Sydney, Australia.

Abstract

BACKGROUND:

Hilar cholangiocarcinoma (HC) is invariably fatal without surgical intervention. The primary aim of the current study was to report overall survival and recurrence-free survival outcomes after surgical resection of HC.

METHODS:

Between December 1992 and December 2009, 85 patients were evaluated; of these, 42 patients underwent potentially curative surgery. These patients are the principal subjects of this study. Patients were assessed monthly for the first 3 months and then at 6-month intervals after treatment. Recurrence-free survival and overall survival were determined; 18 clinicopathologic and treatment-related factors associated with recurrence-free survival and overall survival were evaluated through univariate and multivariate analyses.

RESULTS:

No patient was lost to follow-up evaluation. The median follow-up period was 20 months (range, 0-106 mo). The median recurrence-free survival and overall survival after resection was 15 and 28 months, respectively. The 5-year survival rate was 24%. Two factors were associated with overall survival: histologic grade (P = .002) and margin status (P = .033). Only histologic grade (P = .029) was associated with recurrence-free survival.

CONCLUSIONS:

Surgical resection is an efficacious treatment for HC. Patient selection based on identified prognostic factors can improve treatment outcomes.

Copyright © 2011 Elsevier Inc. All rights reserved.

[PubMed - indexed for MEDLINE]
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