Preoperative evaluation with T-staging system for hilar cholangiocarcinoma |
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Authors: | Chen Ru-Fu Li Zhi-Hua Zhou Jia-Jia Wang Jie Chen Ji-Sheng Lin Qing Tang Qi-Bing Peng Ning-Fu Jiang Zhi-Peng Zhou Quan-Bo |
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Institution: | 1. Department of Hepatobiliary Surgery, the Affiliated Second Hospital, Sun Yat-sen University,107 Yan-Jiang Xi Road, GuangZhou 510120, Guangdong Province, China 2. Department of Emergency, the Affiliated Second Hospital, Sun Yat-sen University, 107 Yan-Jiang Xi Road,GuangZhou 510120, Guangdong Province, China 3. Department of Oncology, the Affiliated Second Hospital, Sun Yat-sen University, 107 Yan-Jiang Xi Road,GuangZhou 510120, Guangdong Province, China 4. Department of Hepatobiliary Surgery, the Affiliated Second Hospital, Sun Yat sen University, 107Yan-Jiang Xi Road, GuangZhou 510120,Guangdong Province, China. |
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Abstract: | AIM: To investigate the clinical value of T-staging system in the preoperative assessment of hilar cholangiocarcinoma. METHODS: From March 1993 to January 2006, 85 patients who had cholangiocarcinoma diagnosed by operative tissue-biopsy were placed into one of three stages based on the new T-staging system, and it was evaluated the resectability and survival correlated with T-staging. RESULTS: The likelihood of resection and achieving tumor-free margin decreased progressively with increasing T stage (P < 0.05). The cumulative 1-year survival rates of T1, T2 and T3 patients were 71.8%, 50.8% and 12.9% respectively, and the cumulative 3-year survival rate was 34.4%, 18.2% and 0% respectively; the survival of different stage patients differed markedly (P < 0.001). Median survival in the hepatic resection group was greater than in the group that did not undergo hepatic resection (28 mo vs 18 mo; P < 0.05). The overall accuracy for combined MRCP and color Doppler Ultrasonagraphy detecting disease was higher than that of combined using CT and color Doppler Ultrasonagraphy (91.4% vs 68%; P < 0.05 ). And it was also higher in detecting port vein involvement (90% vs 54.5%; P < 0.05).CONCLUSION: The proposed staging system for hilar cholangiocarcinoma can accurately predict resectability, the likelihood of metastatic disease, and survival. A concomitant partial hepatectomy would help to attain curative resection and the possibility of long- term survival. MRCP/MRA coupled with color Doppler Ultrasonagraphy was necessary for preoperative evaluation of hilar cholangiocarcinoma. |
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Keywords: | Hilar cholangiocarcinoma Preoperative staging Survival rate Surgical treatment |
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