Survival after resection of perihilar cholangiocarcinoma in patients with lymph node metastases. HPB (Oxford) 2017 Aug;19(8):735-740
Date
05/28/2017Pubmed ID
28549744Pubmed Central ID
PMC5907486DOI
10.1016/j.hpb.2017.04.014Scopus ID
2-s2.0-85019648896 (requires institutional sign-in at Scopus site) 24 CitationsAbstract
BACKGROUND: The aim of this study was to compare patients with PHC with lymph node metastases (LN+) who underwent a resection with patients who did not undergo resection because of locally advanced disease at exploratory laparotomy.
METHODS: Consecutive LN+ patients who underwent a resection for PHC in 12 centers were compared with patients who did not undergo resection because of locally advanced disease at exploratory laparotomy in 2 centers.
RESULTS: In the resected cohort of 119 patients, the median overall survival (OS) was 19 months and the estimated 1-, 3- and 5-year OS was 69%, 27% and 13%, respectively. In the non-resected cohort of 113 patients, median OS was 12 months and the estimated 1-, 3- and 5-year OS was 49%, 7%, and 3%, respectively. OS was better in the resected LN+ cohort (p < 0.001). Positive resection margin (hazard ratio [HR]: 1.54; 95%CI: 0.97-2.45) and lymphovascular invasion (LVI) (HR: 1.71; 95%CI: 1.09-2.69) were independent poor prognostic factors in the resected cohort.
CONCLUSION: Patients with PHC who underwent a resection for LN+ disease had better OS than patients who did not undergo resection because of locally advanced disease at exploratory laparotomy. LN+ PHC does not preclude 5-year survival after resection.
Author List
Buettner S, van Vugt JLA, Gaspersz MP, Coelen RJS, Roos E, Labeur TA, Margonis GA, Ethun CG, Maithel SK, Poultsides G, Tran T, Idrees K, Isom CA, Fields RC, Krasnick BA, Weber SM, Salem A, Martin RCG, Scoggins CR, Shen P, Mogal HD, Schmidt C, Beal E, Hatzaras I, Shenoy R, IJzermans JNM, van Gulik TM, Pawlik TM, Groot Koerkamp BMESH terms used to index this publication - Major topics in bold
AgedBile Duct Neoplasms
Chemotherapy, Adjuvant
Female
Hepatectomy
Humans
Kaplan-Meier Estimate
Klatskin Tumor
Lymphatic Metastasis
Male
Middle Aged
Netherlands
Proportional Hazards Models
Radiotherapy, Adjuvant
Retrospective Studies
Risk Factors
Time Factors
Treatment Outcome
United States