Clinicopathological Factors Predicting Long‐term Overall Survival after Hepatectomy for Peripheral Cholangiocarcinoma

Abstract

Peripheral cholangiocarcinoma (PCC) is clinically challenging because patients typically do not present until the disease is relatively advanced. Three-year to 5-year survival rates even with resection thus remain dismal. This study aimed to determine the clinicopathological factors for predicting overall survival longer than 5 years in PCC patients treated with hepatectomy. From 1977 to 1997, the clinicopatholgical features of 11 PCC patients who underwent hepatectomy with long-term overall survival (group A) were reviewed. Comparison was made with the clinical features and factors influencing the outcome of 70 PCC patients who survived less than 5 years after hepatectomy (group B). Of 81 PCC patients undergoing hepatectomy, 11 (13.6%) were 5-year survivors. The 81 PCC patients comprised 32 men and 49 women, with a mean age of 56.0 years (range: 34-83 years). Univariate analysis showed that female gender, absence of physical findings, a higher percentage of presence of mucobilia, early staged tumor, intraductal papillary tumor growth, and curative hepatic resection were more frequent in group A patients than group B patients. However, multivariate logistic regression analysis showed that absence of physical findings, presence of mucobilia, early staged tumor, and curative hepatic resection were the four independent factors differentiating group A from B patients. The 1-, 3-, 5-, and 10-year survival rates of the group A patients were 100%, 100%, 100%, and 40%, whereas those of the group B patients were 46.0%, 9.5%, 0%, and 0%, respectively. Absence of physical findings, presence of mucobilia, early staged tumor, and curative hepatectomy could independently predict PCC patients with long-term overall survival after hepatectomy.

Transarterial chemoembolization in the treatment of patients with unresectable cholangiocarcinoma: Results and prognostic factors governing treatment success

“…14,24,25 Surgical resection showed a median survival time of 13-44 months (26)(27)(28), and a 5-year survival rate of about 4.1-43%. [26][27][28][29][30] For most of the patients, palliative therapeutic options exist and are based on multimodal promising combinations including systemic chemotherapy, endoscopic biliary stenting, radiation therapy and photodynamic treatment. 26,[31][32][33][34][35][36] Those palliative treatment options can help to improve survival, relieve symptoms and enhance the patient's quality of life.…”

Advances in diagnosis, treatment and palliation of cholangiocarcinoma: 1990-2009

“…DeOliveira et al [67] , 2007 34 40 63 Miwa et al [195] , 2006 41 29 36 Jan et al [196] , 2005 81 15 NR Ohtsuka et al [197] , 2003 50 23 NR Uenishi et al [198] , 2001 28 27 67 Inoue et al [199] , 2000 52 36 55 Yamamoto et al [200] , 1999 83 23 53 Madariaga et al [201] , 1998 34 35 41…”

“…Lymph node dissection during resection of ICC is not recommended as it does not improve patients' survival [193,194] . Current outcomes after surgical resection have improved in comparison to historical data with 5-year survival rates ranging from 20% to 40% (Table 9) [195][196][197][198][199][200][201] . Predictors of poor outcomes include: positive resection margins, lymphatic and vascular invasion and periductal infiltrating disease [202,203] .…”

“…Predictors of poor outcomes include: positive resection margins, lymphatic and vascular invasion and periductal infiltrating disease [202,203] . The most common site of recurrence after surgical resection is within the liver [196] .…”

Early bile duct cancer

“…Over half of patients with advanced bile duct cancer present with unresectable malignancies, and the 5-year survival rate of these patients is approximately 15%-35% even after curative resections [1,2,13,25,31,51,52] . Early bile duct cancer patients should have markedly better surgical outcomes than advanced bile duct cancer patients.…”