Outcomes after vascular resection during curative-intent resection for hilar cholangiocarcinoma: a multi-institution study from the US extrahepatic biliary malignancy consortium |
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| Authors: | Gregory V. Schimizzi Linda X. Jin Jesse T. Davidson Bradley A. Krasnick Cecilia G. Ethun Timothy M. Pawlik George Poultsides Thuy Tran Kamran Idrees Chelsea A. Isom Sharon M. Weber Ahmed Salem William G. Hawkins Steven M. Strasberg Maria B. Doyle William C. Chapman Robert C.G. Martin Charles Scoggins Ryan C. Fields |
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| Affiliation: | 1. Department of Surgery and the Alvin J. Siteman Cancer Center, Washington University School of Medicine, St Louis, MO, United States;2. Division of Surgical Oncology, Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, GA, United States;3. Division of Surgical Oncology, Department of Surgery, The Johns Hopkins Hospital, Baltimore, MD, United States;4. Department of Surgery, Stanford University Medical Center, Stanford, CA, United States;5. Division of Surgical Oncology, Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, United States;6. Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States;7. Division of Surgical Oncology, Department of Surgery, University of Louisville, Louisville, KY, United States;8. Department of Surgery, Wake Forest University, Winston–Salem, NC, United States;9. Division of Surgical Oncology, The Ohio State University Comprehensive Cancer Center, Columbus, OH, United States;10. Department of Surgery, New York University, New York, NY, United States |
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| Abstract: | ![]()
BackgroundSurgical resection is the cornerstone of curative-intent therapy for patients with hilar cholangiocarcinoma (HC). The role of vascular resection (VR) in the treatment of HC in western centres is not well defined.MethodsUtilizing data from the U.S. Extrahepatic Biliary Malignancy Consortium, patients were grouped into those who underwent resection for HC based on VR status: no VR, portal vein resection (PVR), or hepatic artery resection (HAR). Perioperative and long-term survival outcomes were analyzed.ResultsBetween 1998 and 2015, 201 patients underwent resection for HC, of which 31 (15%) underwent VR: 19 patients (9%) underwent PVR alone and 12 patients (6%) underwent HAR either with (n = 2) or without PVR (n = 10). Patients selected for VR tended to be younger with higher stage disease. Rates of postoperative complications and 30-day mortality were similar when stratified by vascular resection status. On multivariate analysis, receipt of PVR or HAR did not significantly affect OS or RFS.ConclusionIn a modern, multi-institutional cohort of patients undergoing curative-intent resection for HC, VR appears to be a safe procedure in a highly selected subset, although long-term survival outcomes appear equivalent. VR should be considered only in select patients based on tumor and patient characteristics. |
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| Keywords: | Correspondence: Ryan C. Fields Washington University School of Medicine 660 South Euclid Avenue Campus Box 8109 St. Louis MO 63110-8109 United States. |
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