Relationship of tumor size with pathological and prognostic factors for hilar cholangiocarcinoma

Objective: To determine the correlation of different tumor-size cutoffs with prognostic factors and survival outcomes to provide a reference for the modification of the T-stage classification in the DeOliveira staging system for hilar cholangiocarcinoma (HCCA). Materials and Methods: We retrospectively analyzed 216 patients who underwent curative surgery for HCCA (mean tumor diameter, 2.8 cm) between 2000 and 2013. Univariate and multivariate logistic regression were used to assess the correlation of tumor-size cutoffs with various factors. Results: Tumor differentiation (odds ratio [OR]: 1.649, 95% confidence interval [CI]: 1.065-2.555, P = 0.025), node status (OR: 1.971, 95% CI: 1.060-3.664, P = 0.032), resection margin (OR: 2.465, 95% CI: 1.024-5.937, P = 0.044), and hepatectomy (OR: 2.373, 95% CI: 1.226-4.593, P = 0.01) were independently correlated with the 2-cm cutoff, while tumor differentiation (OR: 1.755, 95% CI: 1.062-2.091, P = 0.028), node status (OR: 2.166, 95% CI: 1.054-4.452, P = 0.035), and tumor margin (OR: 2.539, 95% CI: 1.089-5.919, P = 0.031) were independently associated with the 3-cm cutoff. Conclusions: The 2-cm and 3-cm cutoffs were strongly correlated with resection margin, node status, tumor differentiation and survival. The 2-cm cutoff may be added to the DeOliveira staging system.