ABSTRACT
Objective:To compare the relationship between the operative strategies and clinical outcomes of type Ⅲ and Ⅳ hilar chol-angiocarcinomas(HCs).Methods:We retrospectively analyzed the clinical data and long-term outcomes for 50 cases of type Ⅲ and Ⅳ HC that underwent surgery at the Tianjin Medical University Cancer Hospital.Results:Fifty patients were followed up and the median follow-up duration was 27 months.The hilar limited hepatectomy group included 13 cases;the median disease-free survival was 6 months,and 1-and 2-year disease-free survival rates were 30.8% and 23.1%,respectively.The median overall survival was 20 months, and the 1-and 2-year overall survival rates were 76.9% and 38.5%,respectively.The extended hepatectomy group included 37 cases;the median disease-free survival was 14 months,and 1-and 2-year disease-free survival rates were 59.5% and 32.4%,respectively.The median overall survival was 37 months,and the 1-and 2-year overall survival rates were 83.8% and 51.4%,respectively.Compared with the hilar limited hepatectomy group,the extended hepatectomy group had significantly longer median disease-free and overall survival(P<0.05).The 1-and 2-year disease-free and overall survival rates were higher for the extended hepatectomy group.There was no significant difference in morbidity and mortality between the two groups(P>0.05).Conclusions:Extended hepatectomy is a safe operation that delays recurrence at early time points and improves the prognosis for patients with type Ⅲ and Ⅳ HC.