Journal
EJSO
Volume 38, Issue 12, Pages 1197-1203Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.ejso.2012.08.009
Keywords
Cholangiocarcinoma; Hepatectomy; Prognosis
Funding
- Youth Research Projects of the Shanghai Health Bureau [20114Y125]
- Youth Start-up Funding of Second Military Medical University [2010QN23]
- Shanghai Natural Science Foundation [114119b1400]
- Shanghai Talent Development Funds [2010022]
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Purpose: To identify prognostic predictors for overall survival of patients with hilar cholangiocarcinoma of Bismuth type III and IV (HCBT34), and to determine survival benefit and safety of total caudate lobectomy (TCL) in a Chinese centre. Methods: From January 2001 to December 2010, 171 patients with the diagnosis of HCBT34, who underwent a potentially curative resection, were included in this study. Cox proportional hazards regression models were used to determine the association between possible prognostic variables and survival time. Curative resectability rate, morbidity and mortality were investigated also. Results: Resection with TCL was significantly associated with more opportunity to achieve curative resection (p < 0.01), did not accompany with more morbidity (p = 0.39) and mortality (p = 0.67). Cox regression analysis demonstrated positive resection margins [Relative Risk (RR) 3.6, 95% CI 3.5-3.71, not well differentiation (RR 2.9, 95% Cl 2.7-3.1), higher preoperative scrum peak CA 19-9 level (RR 1.6, 95% CI 1.5-1.7) and regional lymph nodes involvement (RR 1.5, 95% CI 1.4-1.6) as independent adverse prognostic variables. Conclusions: Resection with TCL offers a long-term survival opportunity for HCBT34, with high curative resectability rates and an acceptable safety profile. (C) 2012 Elsevier Ltd. All rights reserved.
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