Prognosis of perihilar cholangiocarcinoma: Hilar bile duct cancer versus intrahepatic cholangiocarcinoma involving the hepatic hilus

Tsuyoshi Sano, Kazuaki Shimada, Yoshihiro Sakamoto, Hidenori Ojima, Minoru Esaki, Tomoo Kosuge

Research output: Contribution to journalArticle

55 Citations (Scopus)

Abstract

Background: Clinically hepatobiliary resection is indicated for both hilar bile duct cancer (BDC) and intrahepatic cholangiocarcinoma involving the hepatic hilus (CCC). The aim of this study was to compare the long-term outcome of BDC and CCC. Methods: Between 1990 and 2004, we surgically treated 158 consecutive patients with perihilar cholangiocarcinoma. The clinicopathological data on all of the patients were analyzed retrospectively. Results: The overall 3-year survival rate, 5-year survival rate, and median survival time for BDC patients were 48.4%, 38.4 %, and 33.7 months, respectively, and 35.8%, 24.5 %, and 22.7 months, respectively, in CCC patients (P = .033). On multivariate analysis, three independent factors were related to longer survival in BDC patients: achieved in curative resection with cancer free margin (R0) (P = .024, odds ratio 1.862), well differentiated or papillary adenocarcinoma (P = .011, odds ratio 2.135), and absence of lymph node metastasis (P < .001, odds ratio 3.314). Five factors were related to longer survival in CCC patients: absence of intrahepatic daughter nodules (P < .001, odds ratio 2.318), CEA level ≤2.9 ng/mL (P = .005, odds ratio 2.606), no red blood cell transfusion requirement (P = .016, odds ratio 2.614), absence or slight degree of lymphatic system invasion (P < .001, odds ratio 4.577), and negative margin of the proximal bile duct (P = .003, odds ratio 7.398). Conclusions: BDC and CCC appear to have different prognoses after hepatobiliary resection. Therefore, differentiating between these two categories must impact the prediction of postoperative survival in patients with perihilar cholangiocarcinoma.

Original languageEnglish
Pages (from-to)590-599
Number of pages10
JournalAnnals of Surgical Oncology
Volume15
Issue number2
DOIs
Publication statusPublished - 2008 Feb
Externally publishedYes

Fingerprint

Klatskin Tumor
Bile Duct Neoplasms
Cholangiocarcinoma
Odds Ratio
Liver
Survival
Survival Rate
Papillary Adenocarcinoma
Erythrocyte Transfusion
Lymphatic System
Bile Ducts
Multivariate Analysis
Lymph Nodes
Neoplasm Metastasis

Keywords

  • Hepatobiliary resection
  • Hilar bile duct cancer
  • Intrahepatic cholangiocarcinoma

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Prognosis of perihilar cholangiocarcinoma : Hilar bile duct cancer versus intrahepatic cholangiocarcinoma involving the hepatic hilus. / Sano, Tsuyoshi; Shimada, Kazuaki; Sakamoto, Yoshihiro; Ojima, Hidenori; Esaki, Minoru; Kosuge, Tomoo.

In: Annals of Surgical Oncology, Vol. 15, No. 2, 02.2008, p. 590-599.

Research output: Contribution to journalArticle

Sano, Tsuyoshi ; Shimada, Kazuaki ; Sakamoto, Yoshihiro ; Ojima, Hidenori ; Esaki, Minoru ; Kosuge, Tomoo. / Prognosis of perihilar cholangiocarcinoma : Hilar bile duct cancer versus intrahepatic cholangiocarcinoma involving the hepatic hilus. In: Annals of Surgical Oncology. 2008 ; Vol. 15, No. 2. pp. 590-599.
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abstract = "Background: Clinically hepatobiliary resection is indicated for both hilar bile duct cancer (BDC) and intrahepatic cholangiocarcinoma involving the hepatic hilus (CCC). The aim of this study was to compare the long-term outcome of BDC and CCC. Methods: Between 1990 and 2004, we surgically treated 158 consecutive patients with perihilar cholangiocarcinoma. The clinicopathological data on all of the patients were analyzed retrospectively. Results: The overall 3-year survival rate, 5-year survival rate, and median survival time for BDC patients were 48.4{\%}, 38.4 {\%}, and 33.7 months, respectively, and 35.8{\%}, 24.5 {\%}, and 22.7 months, respectively, in CCC patients (P = .033). On multivariate analysis, three independent factors were related to longer survival in BDC patients: achieved in curative resection with cancer free margin (R0) (P = .024, odds ratio 1.862), well differentiated or papillary adenocarcinoma (P = .011, odds ratio 2.135), and absence of lymph node metastasis (P < .001, odds ratio 3.314). Five factors were related to longer survival in CCC patients: absence of intrahepatic daughter nodules (P < .001, odds ratio 2.318), CEA level ≤2.9 ng/mL (P = .005, odds ratio 2.606), no red blood cell transfusion requirement (P = .016, odds ratio 2.614), absence or slight degree of lymphatic system invasion (P < .001, odds ratio 4.577), and negative margin of the proximal bile duct (P = .003, odds ratio 7.398). Conclusions: BDC and CCC appear to have different prognoses after hepatobiliary resection. Therefore, differentiating between these two categories must impact the prediction of postoperative survival in patients with perihilar cholangiocarcinoma.",
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AU - Sano, Tsuyoshi

AU - Shimada, Kazuaki

AU - Sakamoto, Yoshihiro

AU - Ojima, Hidenori

AU - Esaki, Minoru

AU - Kosuge, Tomoo

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AB - Background: Clinically hepatobiliary resection is indicated for both hilar bile duct cancer (BDC) and intrahepatic cholangiocarcinoma involving the hepatic hilus (CCC). The aim of this study was to compare the long-term outcome of BDC and CCC. Methods: Between 1990 and 2004, we surgically treated 158 consecutive patients with perihilar cholangiocarcinoma. The clinicopathological data on all of the patients were analyzed retrospectively. Results: The overall 3-year survival rate, 5-year survival rate, and median survival time for BDC patients were 48.4%, 38.4 %, and 33.7 months, respectively, and 35.8%, 24.5 %, and 22.7 months, respectively, in CCC patients (P = .033). On multivariate analysis, three independent factors were related to longer survival in BDC patients: achieved in curative resection with cancer free margin (R0) (P = .024, odds ratio 1.862), well differentiated or papillary adenocarcinoma (P = .011, odds ratio 2.135), and absence of lymph node metastasis (P < .001, odds ratio 3.314). Five factors were related to longer survival in CCC patients: absence of intrahepatic daughter nodules (P < .001, odds ratio 2.318), CEA level ≤2.9 ng/mL (P = .005, odds ratio 2.606), no red blood cell transfusion requirement (P = .016, odds ratio 2.614), absence or slight degree of lymphatic system invasion (P < .001, odds ratio 4.577), and negative margin of the proximal bile duct (P = .003, odds ratio 7.398). Conclusions: BDC and CCC appear to have different prognoses after hepatobiliary resection. Therefore, differentiating between these two categories must impact the prediction of postoperative survival in patients with perihilar cholangiocarcinoma.

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