Faculty Collaboration Database

Conditional probability of long-term survival after resection of hilar cholangiocarcinoma. HPB (Oxford) 2016 Jun;18(6):510-7

Date

06/19/2016

Pubmed ID

27317955

Pubmed Central ID

PMC4913135

DOI

10.1016/j.hpb.2016.04.001

Scopus ID

2-s2.0-84974845890 (requires institutional sign-in at Scopus site)   35 Citations

Abstract

BACKGROUND: While traditional survival analyses focus on factors determined at the time of surgery, conditional survival (CS) estimates prognosis relative to time following treatment. We sought to compare actuarial and CS among patients undergoing curative intent surgery for hilar cholangiocarcinoma.

METHODS: 242 patients undergoing surgery between 2000 and 2014 were identified using a multi-institutional database. CS was calculated as the probability of surviving an additional 3 years, given that the patient had already survived "x" years from surgery.

RESULTS: Median patient age was 67 years (IQR: 57-73) and most patients were male (n = 140, 57.9%). Lymph node metastases were noted in 79 (32.6%) patients while an R0 margin was obtained in 66.1% (n = 160). Median OS was 22.3 months. Actuarial survival decreased over time from 46.3% at 2 years following surgery to 18.2% at 5 years; in contrast, the 3-year CS (CS3) increased with time (CS3 at 2 years was 39.3% versus 54.4% at 5 years). CS3 exceeded actuarial survival for high-risk patients with patients with perineural invasion demonstrating an actuarial survival of 15.4% at 5 years versus CS3 of 37.6% at 2 years following surgery (Δ = 22.2%).

CONCLUSIONS: CS provides a more accurate, dynamic estimate for survival, especially among high-risk patients.

Author List

Buettner S, Margonis GA, Kim Y, Gani F, Ethun CG, Poultsides G, Tran T, Idrees K, Isom CA, Fields RC, Krasnick B, Weber SM, Salem A, Martin RC, Scoggins CR, Shen P, Mogal HD, Schmidt C, Beal E, Hatzaras I, Shenoy R, Maithel SK, Pawlik TM

MESH terms used to index this publication - Major topics in bold

Aged
Bile Duct Neoplasms
Databases, Factual
Female
Hepatectomy
Humans
Kaplan-Meier Estimate
Klatskin Tumor
Lymphatic Metastasis
Male
Margins of Excision
Middle Aged
Postoperative Complications
Probability
Proportional Hazards Models
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
United States