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Surgical resection for hilar cholangiocarcinoma
Author(s) -
Strong Russell W.,
Lynch Stephen V.
Publication year - 1995
Publication title -
journal of hepato‐biliary‐pancreatic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 0944-1166
DOI - 10.1007/bf02350904
Subject(s) - medicine , grading (engineering) , surgery , retrospective cohort study , survival analysis , survival rate , cohort , gastroenterology , civil engineering , engineering
A retrospective analysis of 62 patients who underwent resection for hilar cholangiocarcinoma performed between 1981–1994 was undertaken. Type I lesions and patients whose operations were performed less than 24 months prior to analysis were excluded, leaving a study cohort of 48 patients (27 male: 21 female, median age 66 years, range 23–86 years). Median post‐operative stay was 20 days (8–60) with peri‐operative mortality of 10.4%. Histopathological grading of paraffin sections of excised tumours was made, using standard criteria, into poor, moderate, and well differentiated lesions, and the three sub‐groups were separately analysed. Patients with poorly differentiated lesions ( n =16) had a median survival of 7 months (range 0–24), with 1‐and 2‐year survival of 19% and 0%, respectively. The median survival of patients with moderately differentiated tumours ( n =20) was 27 months (range 0–84), with 1‐, 2‐, 3‐, and 5‐year survival of 70%, 55%, 35%, and 22%, respectively. Those with well differentiated carcinomas ( n =12) fared better, with a median survival of 62 months (range 16–120) and 1‐, 2‐, 3‐, and 5‐year survival of 100%, 66%, 66%, and 58%, respectively. Differences in survival were highly significant at P <0.0001. Patients with poorly differentiated tumours would be best served by non‐surgical intervention if this differentiation could be reliably made pre‐operatively. Conversely, those with more favourable histological grading are potentially curable by an aggressive radical resection.