Faculty Collaboration Database

Outcomes after vascular resection during curative-intent resection for hilar cholangiocarcinoma: a multi-institution study from the US extrahepatic biliary malignancy consortium. HPB (Oxford) 2018 Apr;20(4):332-339

Date

11/25/2017

Pubmed ID

29169904

Pubmed Central ID

PMC5970648

DOI

10.1016/j.hpb.2017.10.003

Scopus ID

2-s2.0-85034634913 (requires institutional sign-in at Scopus site)   37 Citations

Abstract

BACKGROUND: Surgical resection is the cornerstone of curative-intent therapy for patients with hilar cholangiocarcinoma (HC). The role of vascular resection (VR) in the treatment of HC in western centres is not well defined.

METHODS: Utilizing data from the U.S. Extrahepatic Biliary Malignancy Consortium, patients were grouped into those who underwent resection for HC based on VR status: no VR, portal vein resection (PVR), or hepatic artery resection (HAR). Perioperative and long-term survival outcomes were analyzed.

RESULTS: Between 1998 and 2015, 201 patients underwent resection for HC, of which 31 (15%) underwent VR: 19 patients (9%) underwent PVR alone and 12 patients (6%) underwent HAR either with (n = 2) or without PVR (n = 10). Patients selected for VR tended to be younger with higher stage disease. Rates of postoperative complications and 30-day mortality were similar when stratified by vascular resection status. On multivariate analysis, receipt of PVR or HAR did not significantly affect OS or RFS.

CONCLUSION: In a modern, multi-institutional cohort of patients undergoing curative-intent resection for HC, VR appears to be a safe procedure in a highly selected subset, although long-term survival outcomes appear equivalent. VR should be considered only in select patients based on tumor and patient characteristics.

Author List

Schimizzi GV, Jin LX, Davidson JT 4th, Krasnick BA, Ethun CG, Pawlik TM, Poultsides G, Tran T, Idrees K, Isom CA, Weber SM, Salem A, Hawkins WG, Strasberg SM, Doyle MB, Chapman WC, Martin RCG, Scoggins C, Shen P, Mogal HD, Schmidt C, Beal E, Hatzaras I, Shenoy R, Maithel SK, Fields RC

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

Aged
Bile Duct Neoplasms
Cholecystectomy
Databases, Factual
Female
Hepatectomy
Hepatic Artery
Humans
Klatskin Tumor
Male
Middle Aged
Neoplasm Grading
Neoplasm Staging
Pancreaticoduodenectomy
Portal Vein
Postoperative Complications
Retrospective Studies
Risk Factors
Time Factors
Treatment Outcome
United States
Vascular Surgical Procedures