Ten-year experience in surgical treatment of hilar cholangiocarcinoma / 中华消化外科杂志

ABSTRACT

Objective To summarize the experiences of a single treatment group in surgical treatment of hilar cholangiocarcinoma during the past 10 years. Methods From January 2000 to December 2009, 1572 patients with hilar cholangiocarcinoma were admitted to the Eastern Hepatobiliary Surgery Hospital, and the clini-cal data of 462 patients in our treatment group were retrospectively analyzed. Among the patients, 314 received surgical treatment, and the remaining 148 received conservative interventions or refused any therapy. Factors that may have influenced the prognosis were analyzed by the Kaplan-Meier method, Log-rank test and Cox proportional hazards model. The correlation of different factors was analyzed by the chi-square test. Results A total of 314 patients underwent surgical treatment and tumor resection was performed in 237 patients, including 174 with R0 resection, 17 with R1 resection, and 46 with R2 resection. There were 91 patients with postoperative complications and 10 in-hospital deaths. A total of 260 patients had been followed up for 5-113 months, and the overall 1-, 3-, and 5-year survival rates were 71.7% , 32.6% and 10.9% , respectively; the 1-, 3-, and 5-year survival rates of patients with R0 resection were 76. 9% , 48. 6% and 32. 7% , respectively, with a median survival time of 35 months. R0 resection, TNM staging, regional lymph node involvement and tumor differentiation were the independent prognostic factors (RR = 2. 1, 1.9,2.2, 1.7, P<0.05). Conclusions Curative resection is the treatment of choice for hilar cholangiocarcinoma. Preoperative systematic evaluation and preparation can improve the radical resection rate and reduce postoperative morbidity.