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

Authors
 Min Soo Cho  ;  Sung Hoon Kim  ;  Seung Woo Park  ;  Jin Hong Lim  ;  Gi Hong Choi  ;  Joon Seong Park  ;  Jae Bock Chung  ;  Kyung Sik Kim 
Citation
 JOURNAL OF GASTROINTESTINAL SURGERY, Vol.16(9) : 1672-1679, 2012 
Journal Title
 JOURNAL OF GASTROINTESTINAL SURGERY 
ISSN
 1091-255X 
Issue Date
2012
MeSH
Adult ; Aged ; Aged, 80 and over ; Bile Duct Neoplasms/mortality ; Bile Duct Neoplasms/pathology ; Bile Duct Neoplasms/surgery* ; Bile Ducts, Intrahepatic* ; Cholangiocarcinoma/mortality ; Cholangiocarcinoma/pathology ; Cholangiocarcinoma/surgery* ; Female ; Hepatectomy ; Humans ; Male ; Middle Aged ; Neoplasm Invasiveness ; Retrospective Studies ; Survival Analysis ; Treatment Outcome
Keywords
Hilar cholangiocarcinoma ; Curative resection ; Liver optimization
Abstract
BACKGROUND: 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. 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.
Full Text
http://link.springer.com/article/10.1007%2Fs11605-012-1960-0
DOI
22798185
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kyung Sik(김경식) ORCID logo https://orcid.org/0000-0001-9498-284X
Park, Seung Woo(박승우) ORCID logo https://orcid.org/0000-0001-8230-964X
Park, Joon Seong(박준성) ORCID logo https://orcid.org/0000-0001-8048-9990
Lim, Jin Hong(임진홍)
Chung, Jae Bock(정재복)
Cho, Min Soo(조민수)
Choi, Gi Hong(최기홍) ORCID logo https://orcid.org/0000-0002-1593-3773
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/90832
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