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Overall survival peri‐hilar cholangiocarcinoma: R1 resection with curative intent compared to primary endoscopic therapy
Author(s) -
Schiffman Suzanne C.,
Reuter Nathaniel P.,
McMasters Kelly M.,
Scoggins Charles R.,
Martin Robert C.G.
Publication year - 2011
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.22054
Subject(s) - medicine , perioperative , surgery , prospective cohort study , gastroenterology
Background and Objectives Patients with peri‐hilar cholangiocarcinoma who undergo R1 resection with curative intent will have an improved survival compared to patients who were not resected. Methods Review of a prospective hepatobiliary database identified 130 patients. Survival was compared using the log‐rank test. Results Seventy‐nine patients (61%) were resected while 51 (49%) patients were not. Forty‐two patients (54%) had an R0 resection. There was no difference in mean age (69 vs. 67; P = 0.8), BMI (27.8 vs. 27.9; P = 1.0), gender (73% vs. 43% male; P = 0.1), presence of jaundice (77% vs. 64%; P = 0.5), vascular involvement on pre operative imaging (77% vs. 64%; P = 0.5), stent (73.1% vs. 64.3%; P = 0.72), and lobar atrophy (27% vs. 7%, P = 0.2) in the resected versus non‐resected patients. All patients underwent chemotherapy and/or radiation therapy. After a median follow up of 35.6 months the median OSl for all peri‐hilar patients was 16.2 months (95% CI = 11.2–23.4). The median OS for resected patients was 18.9 months (95% CI = 12.5–24.7) versus 5.0 months (95% CI = 0–6.9) for patients not resected ( P < 0.001). The only pre‐operative predictor of OS was resection ( P = 0.041). Vascular invasion, lobar atrophy, and stent placement were not statistically significant predictors. Conclusion Overall survival is improved in patients undergoing R1 resection and multi‐modality therapy compared to patients not resected. J. Surg. Oncol. 2012; 105:91–96. © 2011 Wiley Periodicals, Inc.