Actual Long‐Term Survival Outcome of 403 Consecutive Patients with Hilar Cholangiocarcinoma

Kang, Mee Joo; Jang, Jin–Young; Chang, Jihoon; Shin, Yong Chan; Lee, Dooho; Kim, Hong Beom; Kim, Sun Whe

doi:10.1007/s00268-016-3551-9

Cited by 53 publications

(65 citation statements)

References 48 publications

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“…Although extended liver resection combined with extrahepatic bile duct resection and systematic dissection of regional lymph nodes have been performed within the last decades, the overall prognosis is still unfavorable. In contrast, several recent studies indicated that adjuvant therapy could improve survival in resected HC, especially for patients with lymph node metastasis and positive surgical margin . Thus, a better understanding of the biological characteristics of HC might help to predict patients’ prognosis and develop a more individualized treatment.…”

Section: Introductionmentioning

confidence: 96%

Prognostic significance of mucinous component in hilar cholangiocarcinoma after curative‐intent resection

et al. 2019

Journal of Surgical Oncology

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Background The presence of mucinous component has been indicated to have a prognostic value in adenocarcinoma. However, little is known regarding the clinicopathological characteristics and prognosis of hilar cholangiocarcinoma (HC) with mucinous component (HCM). Methods Between January 1996 and December 2014, a total of 61 HCM patients who underwent curative‐intent resection at West China Hospital were retrospectively reviewed. The clinicopathological characteristics and survival of these patients were compared with a large cohort of 217 surgically resected conventional HC patients during the same period. Results The clinicopathological characteristics of HCM were distinct from conventional HC, including higher CA19‐9 levels, larger tumor sizes, less differentiation, and a high frequency of liver parenchyma invasion, portal vein invasion, and lymphovascular invasion. HCM patients showed significantly worse recurrence‐free survival (13.4 vs 23.9 months; P = .011) and overall survival (18.2 vs 32.1 months; P = .019) compared with conventional HC patients. Multivariate analysis confirmed liver parenchyma invasion, N stage, surgical margin, and histological grade as independent prognostic factors influencing overall survival in HCM patients. Conclusion HCM showed distinct clinicopathological features, more aggressive biological behaviors, and poor prognosis in comparison with conventional HC. Therefore, the mucinous component is an adverse prognostic factor for HC.

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Section: Introductionmentioning

confidence: 96%

Prognostic significance of mucinous component in hilar cholangiocarcinoma after curative‐intent resection

et al. 2019

Journal of Surgical Oncology

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“…Relative report is rare in the world up to now. Hilar cholangiocarcinoma has a poor prognosis, especially when it occurs with lymph node metastasis or vessel invasion [5,6]. We recently had a patient who underwent a pure laparoscopic extended right hepatectomy and lymph node dissection and hepaticojejunostomy for a type IIIa hilar cholangiocarcinoma.…”

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confidence: 99%

Pure laparoscopic radical resection for type IIIa hilar cholangiocarcinoma

et al. 2017

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Background Pure laparoscopic radical resection of hilar cholangiocarcinoma is still a challenging procedure, in which laparoscopic lymphadenectomy, hemihepatectomy with caudate lobectomy, and hepaticojejunostomy were included [1][2][3][4]. Relative report is rare in the world up to now. Hilar cholangiocarcinoma has a poor prognosis, especially when it occurs with lymph node metastasis or vessel invasion [5,6]. We recently had a patient who underwent a pure laparoscopic extended right hepatectomy and lymph node dissection and hepaticojejunostomy for a type IIIa hilar cholangiocarcinoma. Methods The tumor was 20 9 15 9 12 mm in diameter and located in the right bile duct and common hepatic duct. Radiological examination showed that hepatic artery and portal vein was not invaded. After the division and mutilation of the right hepatic artery and the right portal vein, short hepatic veins were divided and cut off with clip and ultrasound knife from the anterior face of the vena cava. Mobilization was performed after the devascularization of the right liver, followed by the transection of liver parenchymal with CUSA and ultrasound knife. Finally, left hepatic bile duct jejunum Roux-en-Y reconstruction was performed.Results This patient underwent successfully with a totally laparoscopic procedure. An extended right hepatectomy (right hemihepatectomy combined with caudate lobectomy) and complete lymph node dissection and hepaticojejunostomy were performed in this operation. The operation time was nearly 590 min, and the intraoperative blood loss was about 300 ml. No obvious complication was observed and the postoperative hospital stay was 11 days. The final diagnosis of the hilar cholangiocarcinoma with no lymph node metastasis was pT2bN0M0 stage II (American Joint Committee on Cancer, AJCC). Conclusions Pure laparoscopic resection for hilar cholangiocarcinoma was proved safe and feasible, which enabled the patient to recover early and have an opportunity to receive chemotherapy as soon as possible. We present a video of the described procedure.

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“…As CCA features a very unfavorable prognosis even after successful tumor resection [61-63], new strategies are needed to better understand which patients benefit most from extended liver surgery or systemic therapy and which patients should be offered best supportive care. Prognostic circulating biomarkers for CCA that might help to overcome this challenge are reviewed in the following section.…”

Section: Resultsmentioning

confidence: 99%

Circulating Biomarkers for Cholangiocarcinoma

Loosen

Vucur

Roderburg

et al. 2018

Dig Dis

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Background: Cholangiocarcinoma (CCA) represents the second most common primary liver malignancy. The incidence rate has constantly increased over the last decades and CCA patients face a dismal prognosis with a 5-year survival rate of less than 5% for advanced stage of disease. Surgical tumor resection has remained the only potentially curative treatment option in daily practice but is often not feasible due to advanced disease stage at initial diagnosis. Summary: The early detection of cholangiocarcinoma is essential to provide patients with a potentially curative treatment. Furthermore, prognostic biomarkers represent a valuable tool to offer patients a tailored therapeutic approach in accordance to their life expectancy. The clinically most established biomarker carbohydrate antigen 19–9 shows only a limited diagnostic and prognostic power, encouraging the evaluation of novel biomarkers for cholangiocarcinoma in the last years. Key Massage: In this review, we assess currently available and potential future biomarkers for the diagnosis and prognosis of cholangicarcinoma.

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Actual Long‐Term Survival Outcome of 403 Consecutive Patients with Hilar Cholangiocarcinoma

Abstract: Actual 5-year OS rate after R0 resection of hilar cholangiocarcinoma is 30.1 %. Adjuvant treatment could be beneficial in patients with lymph node metastasis.

Cited by 53 publications

References 48 publications

Prognostic significance of mucinous component in hilar cholangiocarcinoma after curative‐intent resection

Prognostic significance of mucinous component in hilar cholangiocarcinoma after curative‐intent resection

Pure laparoscopic radical resection for type IIIa hilar cholangiocarcinoma

Circulating Biomarkers for Cholangiocarcinoma

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