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20.05.2016 | Original Scientific Report | Ausgabe 10/2016

World Journal of Surgery 10/2016

Actual Long-Term Survival Outcome of 403 Consecutive Patients with Hilar Cholangiocarcinoma

Zeitschrift:
World Journal of Surgery > Ausgabe 10/2016
Autoren:
Mee Joo Kang, Jin-Young Jang, Jihoon Chang, Yong Chan Shin, Dooho Lee, Hong Beom Kim, Sun-Whe Kim
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1007/​s00268-016-3551-9) contains supplementary material, which is available to authorized users.

Abstract

Background

Despite aggressive surgical resection, prognosis of patients with hilar cholangiocarcinoma is still unsatisfactory. There were limited data about actual long-term survival outcome. This study was designed to explore actual long-term survival outcome of hilar cholangiocarcinoma after surgical treatment, and to investigate the characteristics of patients with actual long-term survival.

Methods

The study cohort consisted of 403 consecutive patients with at least 5-year follow-up after surgical treatment for hilar cholangiocarcinoma at Seoul National University Hospital between 1991 and 2010. Prognostic factors were analyzed with Cox proportional hazard models, and the effect of adjuvant treatment was evaluated by propensity score analysis.

Results

Of all patients, R0 resection rate was 41.2 and 63.8 % among intended curative resection. Adjuvant therapy was performed in 48.8 % after curative surgery. Actual 5-year overall survival (OS) rate was 18.9, and 30.1 % after R0 resection. Actual 5-year disease-free survival rate was 25.8 % after resection. Adjuvant treatment improved prognosis in patients with positive metastatic lymph nodes (median OS 21.9 vs. 11.5 months, p = 0.003). Overall recurrence rate was 55.0 %, and distant metastasis (39.7 %) was more frequent than loco-regional recurrence (20.8 %). Lymph node metastasis (p = 0.021) and poor histologic grade (p < 0.001) were independent prognostic factors after curative resection. Patients who survived more than 5 years had less lymph node metastasis (p = 0.025), poor histologic differentiation (p = 0.010), R2 resection (p = 0.040), and recurrence (p < 0.001).

Conclusion

Actual 5-year OS rate after R0 resection of hilar cholangiocarcinoma is 30.1 %. Adjuvant treatment could be beneficial in patients with lymph node metastasis.

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Zusatzmaterial
Supplementary material 1 (DOCX 21 kb)
268_2016_3551_MOESM1_ESM.docx
Literatur
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