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Surgical outcomes and predicting factors of curative resection in patients with hilar cholangiocarcinoma : 10-year single-institution experience

Other Titles
 간문부암 환자에 있어 근치적절제술의 외과적 치료성적과 예측인자 분석에 대한 10년간의 단일 연구기관 경험 
Authors
 조민수 
Issue Date
2013
Description
Dept. of Medicine/석사
Abstract
Objective. The surgical resection of hilar cholangiocarcinoma is extremely challenging because the tumor is closely related with the complicated hilar structures. We investigated to identify the outcomes for patients who underwent surgical resection and to identify the parameters that influenced radical resection.Materials and Methods. From January 2000 to December 2009, 105 patients underwent surgical resection for hilar cholangiocarcinoma. The clinicopathological parameters and surgical outcomes were retrospectively analyzed.Results. There were 15 operative mortalities (14.3%). Seventy-four patients underwent curative resection (70.5%). The median overall survival time for R0, R1, and R2 were 58, 28, and 19 months, respectively. Caudate lobectomy (p=0.044;odds ratio [OR], 4.386) and perineural invasion (p=0.01; OR, 0.062) were correlated with curative resection. Total bilirubin levels of more than 3 g/dl just before the operation (p=0.042; hazard ratio [HR], 2.109) and extent of resection (R1 and 2 vs R0; p=0.05; HR, 2.309) were selected as significantly negative factors affecting overall survival on the multivariate analysis.Conclusions. Caudate lobectomy and neurectomy may be thought of as adjustable territories by the surgeon’s efforts to achieve curative resection. R0 resection achieved through those efforts and liver optimization using preoperative biliary drainage may offer the patients a chance of cure.
Files in This Item:
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Appears in Collections:
1. College of Medicine (의과대학) > Others (기타) > 5. Others
Yonsei Authors
Cho, Min Soo(조민수)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/136477
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