Clinical outcome after resection of early-stage hilar cholangiocarcinoma |
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| Affiliation: | 1. North Western Hepatobiliary Unit, Aintree University Hospital, Liverpool, UK;2. Department of General Surgery, Medical University Vienna, Vienna, Austria;1. Department of Pancreatic Surgery, Huashan Hospital, Fudan University, Shanghai, 200040, China;2. Department of Plastic & Reconstructive Surgery, Shanghai Ninth People''s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200011, China;1. Division of Surgical Oncology, Radboud University Medical Centre, Geert Groteplein Zuid 10, 6525 GA, Nijmegen, the Netherlands;2. Division of Research, Netherlands Comprehensive Cancer Organization (IKNL), Postbus 19079, 3501 DB, Utrecht, the Netherlands;3. Division of Public Health, Erasmus MC University Medical Centre, Wytemaweg 80, 3015 CN, Rotterdam, the Netherlands;4. Division of Surgery, Catharina Hospital, Postbus 1350, 5602 ZA, Eindhoven, the Netherlands;5. Division of Surgery, Elisabeth – TweeSteden Hospital, Doctor Deelenlaan 5, 5042 AD, Tilburg, the Netherlands;1. Department of Intervention, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, Jiangsu, China;2. Department of Oncology, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, Jiangsu, China;3. Department of Ultrasound, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, Jiangsu, China;1. Department of Orthopaedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, Austria;2. Comprehensive Cancer Centre Graz, Graz, Austria;3. Department of Orthopaedic Surgery, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands;4. Division of Oncology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria;5. Department of Experimental Therapeutics, The UT MD Anderson Cancer Center, Sout Campus Research Building 4, 1901 East Road, Houston, TX, USA;6. Division of Thoracic and Hyperbaric Surgery, Medical University of Graz, Auenbruggerplatz 29, 8036, Austria;7. Institute of Pathology, Medical University of Graz, Auenbruggerplatz 25, 8036, Graz, Austria;8. Department of Medical Statistics and Bioinformatics, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands;9. Mathematical Institute Leiden University, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands;1. Department of Breast and Sarcoma Surgery, National Institute of Oncology, Ráth Gy. u. 7-9, 1122, Budapest, Hungary;2. Centre of Radiotherapy, National Institute of Oncology and Department of Oncology, Semmelweis University, Ráth Gy. u. 7-9, 1122, Budapest, Hungary;3. Centre of Radiotherapy, National Institute of Oncology, Ráth Gy.u. 7-9, 1122, Budapest, Hungary;4. Department of Oncology, Semmelweis University, Ráth Gy. u. 7-9, 1122, Budapest, Hungary;5. Department of Breast Surgery, Guy''s and St Thomas''s Hospitals NHS Foundation Trust, Great Maze Pond, London, SE1 9RT, United Kingdom;6. Thoracic Surgery Department, National Institute of Oncology, Ráth Gy.u. 7-9, 1122, Budapest, Hungary;7. Thoracic Surgery Clinic, Semmelweis University, Ráth Gy.u. 7-9, 1122, Budapest, Hungary;8. Department of Molecular Pathology, National Institute of Oncology, Ráth Gy. u. 7-9, 1122, Budapest, Hungary;9. Department of Diagnostic Radiology, National Institute of Oncology, Ráth Gy. u. 7-9, 1122, Budapest, Hungary;10. Department of Nuclear Medicine, National Institute of Oncology, Ráth Gy. u. 7-9, 1122, Budapest, Hungary;11. National Institute of Oncology, Ráth Gy. u. 7-9, 1122, Budapest, Hungary |
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| Abstract: | BackgroundLiver transplantation in patients with unresectable early-stage (<3 cm, node negative) hilar cholangiocarcinoma has been recently reported to be associated with longer survival compared to liver resection and therefore suggested as potential treatment option also in resectable disease. Here, we investigated the outcome of resection in early-stage tumours as the standard of care in an experienced European centre.MethodsPatients with de novo resectable hilar cholangiocarcinomas who underwent liver resection between mid-2009 and December 2017 were classified as early-stage (<3 cm and node negative) or later-stage tumours (≥3 cm and/or node positive), and were investigated with respect to clinical outcome.ResultsFifty-six patients were analyzed of whom 17 had early-stage tumours and 39 had later-stage tumours. The sex ratio (m:f) was 30:26. The median age was 65 years (range 33–80). The median follow-up was 17.0 months (range 0.7–92.4). 5-year overall survival (OS) rates were 82% in patients with early-stage tumours and 23% in patients with later-stage tumours, respectively. Median OS was 89.9 months and 27.6 months, respectively (HR 0.25 (95% CI 0.08–0.84), P = 0.024).ConclusionsIn an experienced European centre, 5-year survival rates after liver resection for early-stage hilar cholangiocarcinoma are comparable with reported outcomes after transplantation. The results of this study question the value of liver transplantation in this setting, especially with respect to the shortage of transplantable organs worldwide. |
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| Keywords: | Hilar cholangiocarcinoma Early-stage tumour Liver resection Clinical outcome |
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