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Prognosis of Perihilar Cholangiocarcinoma: Hilar Bile Duct Cancer versus Intrahepatic Cholangiocarcinoma Involving the Hepatic Hilus

  • Hepatic and Pancreatic Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Clinically hepatobiliary resection is indicated for both hilar bile duct cancer (BDC) and intrahepatic cholangiocarcinoma involving the hepatic hilus (CCC). The aim of this study was to compare the long-term outcome of BDC and CCC.

Methods

Between 1990 and 2004, we surgically treated 158 consecutive patients with perihilar cholangiocarcinoma. The clinicopathological data on all of the patients were analyzed retrospectively.

Results

The overall 3-year survival rate, 5-year survival rate, and median survival time for BDC patients were 48.4%, 38.4 %, and 33.7 months, respectively, and 35.8%, 24.5 %, and 22.7 months, respectively, in CCC patients (P = .033).

On multivariate analysis, three independent factors were related to longer survival in BDC patients: achieved in curative resection with cancer free margin (R0) (P = .024, odds ratio 1.862), well differentiated or papillary adenocarcinoma (P = .011, odds ratio 2.135), and absence of lymph node metastasis (P < .001, odds ratio 3.314). Five factors were related to longer survival in CCC patients: absence of intrahepatic daughter nodules (P < .001, odds ratio 2.318), CEA level ≤2.9 ng/mL (P = .005, odds ratio 2.606), no red blood cell transfusion requirement (P = .016, odds ratio 2.614), absence or slight degree of lymphatic system invasion (P < .001, odds ratio 4.577), and negative margin of the proximal bile duct (P = .003, odds ratio 7.398).

Conclusions

BDC and CCC appear to have different prognoses after hepatobiliary resection. Therefore, differentiating between these two categories must impact the prediction of postoperative survival in patients with perihilar cholangiocarcinoma.

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Acknowledgment

This research was supported in part by a Grant-in-Aid for scientific research from the Ministry of Health and Welfare of Japan.

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Authors and Affiliations

  1. Hepato-Biliary and Pancreatic Surgery Division, National Cancer Center Hospital, Tokyo, Japan

    Tsuyoshi Sano MD, Kazuaki Shimada MD, Yoshihiro Sakamoto MD, Minoru Esaki MD & Tomoo Kosuge MD

  2. Pathology Division, National Cancer Center Research Institute, Tokyo, Japan

    Hidenori Ojima MD

Authors
  1. Tsuyoshi Sano MD
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  2. Kazuaki Shimada MD
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  3. Yoshihiro Sakamoto MD
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  4. Hidenori Ojima MD
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  5. Minoru Esaki MD
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  6. Tomoo Kosuge MD
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Corresponding author

Correspondence to Tsuyoshi Sano MD.

Additional information

T. Sano is currently with: Hepato-Biliary and Pancreatic Surgery Division, Aichi Cancer Center Hospital, Nagoya, Japan.

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Sano, T., Shimada, K., Sakamoto, Y. et al. Prognosis of Perihilar Cholangiocarcinoma: Hilar Bile Duct Cancer versus Intrahepatic Cholangiocarcinoma Involving the Hepatic Hilus. Ann Surg Oncol 15, 590–599 (2008). https://doi.org/10.1245/s10434-007-9687-y

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  • DOI: https://doi.org/10.1245/s10434-007-9687-y

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