TY - JOUR
T1 - Outcomes after vascular resection during curative-intent resection for hilar cholangiocarcinoma
T2 - a multi-institution study from the US extrahepatic biliary malignancy consortium
AU - Schimizzi, Gregory V.
AU - Jin, Linda X.
AU - Davidson, Jesse T.
AU - Krasnick, Bradley A.
AU - Ethun, Cecilia G.
AU - Pawlik, Timothy M.
AU - Poultsides, George
AU - Tran, Thuy
AU - Idrees, Kamran
AU - Isom, Chelsea A.
AU - Weber, Sharon M.
AU - Salem, Ahmed
AU - Hawkins, William G.
AU - Strasberg, Steven M.
AU - Doyle, Maria B.
AU - Chapman, William C.
AU - Martin, Robert C.G.
AU - Scoggins, Charles
AU - Shen, Perry
AU - Mogal, Harveshp D.
AU - Schmidt, Carl
AU - Beal, Eliza
AU - Hatzaras, Ioannis
AU - Shenoy, Rivfka
AU - Maithel, Shishir K.
AU - Fields, Ryan C.
N1 - Publisher Copyright:
© 2017 International Hepato-Pancreato-Biliary Association Inc.
PY - 2018/4
Y1 - 2018/4
N2 - Background: Surgical resection is the cornerstone of curative-intent therapy for patients with hilar cholangiocarcinoma (HC). The role of vascular resection (VR) in the treatment of HC in western centres is not well defined. Methods: Utilizing data from the U.S. Extrahepatic Biliary Malignancy Consortium, patients were grouped into those who underwent resection for HC based on VR status: no VR, portal vein resection (PVR), or hepatic artery resection (HAR). Perioperative and long-term survival outcomes were analyzed. Results: Between 1998 and 2015, 201 patients underwent resection for HC, of which 31 (15%) underwent VR: 19 patients (9%) underwent PVR alone and 12 patients (6%) underwent HAR either with (n = 2) or without PVR (n = 10). Patients selected for VR tended to be younger with higher stage disease. Rates of postoperative complications and 30-day mortality were similar when stratified by vascular resection status. On multivariate analysis, receipt of PVR or HAR did not significantly affect OS or RFS. Conclusion: In a modern, multi-institutional cohort of patients undergoing curative-intent resection for HC, VR appears to be a safe procedure in a highly selected subset, although long-term survival outcomes appear equivalent. VR should be considered only in select patients based on tumor and patient characteristics.
AB - Background: Surgical resection is the cornerstone of curative-intent therapy for patients with hilar cholangiocarcinoma (HC). The role of vascular resection (VR) in the treatment of HC in western centres is not well defined. Methods: Utilizing data from the U.S. Extrahepatic Biliary Malignancy Consortium, patients were grouped into those who underwent resection for HC based on VR status: no VR, portal vein resection (PVR), or hepatic artery resection (HAR). Perioperative and long-term survival outcomes were analyzed. Results: Between 1998 and 2015, 201 patients underwent resection for HC, of which 31 (15%) underwent VR: 19 patients (9%) underwent PVR alone and 12 patients (6%) underwent HAR either with (n = 2) or without PVR (n = 10). Patients selected for VR tended to be younger with higher stage disease. Rates of postoperative complications and 30-day mortality were similar when stratified by vascular resection status. On multivariate analysis, receipt of PVR or HAR did not significantly affect OS or RFS. Conclusion: In a modern, multi-institutional cohort of patients undergoing curative-intent resection for HC, VR appears to be a safe procedure in a highly selected subset, although long-term survival outcomes appear equivalent. VR should be considered only in select patients based on tumor and patient characteristics.
UR - http://www.scopus.com/inward/record.url?scp=85034634913&partnerID=8YFLogxK
U2 - 10.1016/j.hpb.2017.10.003
DO - 10.1016/j.hpb.2017.10.003
M3 - Article
C2 - 29169904
AN - SCOPUS:85034634913
SN - 1365-182X
VL - 20
SP - 332
EP - 339
JO - HPB
JF - HPB
IS - 4
ER -