TY - JOUR
T1 - Survival after resection of perihilar cholangiocarcinoma in patients with lymph node metastases
AU - Buettner, Stefan
AU - van Vugt, Jeroen L.A.
AU - Gaspersz, Marcia P.
AU - Coelen, Robert J.S.
AU - Roos, Eva
AU - Labeur, Tim A.
AU - Margonis, Georgios A.
AU - Ethun, Cecilia G.
AU - Maithel, Shishir K.
AU - Poultsides, George
AU - Tran, Thuy
AU - Idrees, Kamran
AU - Isom, Chelsea A.
AU - Fields, Ryan C.
AU - Krasnick, Bradley A.
AU - Weber, Sharon M.
AU - Salem, Ahmed
AU - Martin, Robert C.G.
AU - Scoggins, Charles R.
AU - Shen, Perry
AU - Mogal, Harveshp D.
AU - Schmidt, Carl
AU - Beal, Eliza
AU - Hatzaras, Ioannis
AU - Shenoy, Rivfka
AU - IJzermans, Jan N.M.
AU - van Gulik, Thomas M.
AU - Pawlik, Timothy M.
AU - Groot Koerkamp, Bas
N1 - Publisher Copyright:
© 2017 International Hepato-Pancreato-Biliary Association Inc.
PY - 2017/8
Y1 - 2017/8
N2 - Background The aim of this study was to compare patients with PHC with lymph node metastases (LN+) who underwent a resection with patients who did not undergo resection because of locally advanced disease at exploratory laparotomy. Methods Consecutive LN+ patients who underwent a resection for PHC in 12 centers were compared with patients who did not undergo resection because of locally advanced disease at exploratory laparotomy in 2 centers. Results In the resected cohort of 119 patients, the median overall survival (OS) was 19 months and the estimated 1-, 3- and 5-year OS was 69%, 27% and 13%, respectively. In the non-resected cohort of 113 patients, median OS was 12 months and the estimated 1-, 3- and 5-year OS was 49%, 7%, and 3%, respectively. OS was better in the resected LN+ cohort (p < 0.001). Positive resection margin (hazard ratio [HR]: 1.54; 95%CI: 0.97–2.45) and lymphovascular invasion (LVI) (HR: 1.71; 95%CI: 1.09–2.69) were independent poor prognostic factors in the resected cohort. Conclusion Patients with PHC who underwent a resection for LN+ disease had better OS than patients who did not undergo resection because of locally advanced disease at exploratory laparotomy. LN+ PHC does not preclude 5-year survival after resection.
AB - Background The aim of this study was to compare patients with PHC with lymph node metastases (LN+) who underwent a resection with patients who did not undergo resection because of locally advanced disease at exploratory laparotomy. Methods Consecutive LN+ patients who underwent a resection for PHC in 12 centers were compared with patients who did not undergo resection because of locally advanced disease at exploratory laparotomy in 2 centers. Results In the resected cohort of 119 patients, the median overall survival (OS) was 19 months and the estimated 1-, 3- and 5-year OS was 69%, 27% and 13%, respectively. In the non-resected cohort of 113 patients, median OS was 12 months and the estimated 1-, 3- and 5-year OS was 49%, 7%, and 3%, respectively. OS was better in the resected LN+ cohort (p < 0.001). Positive resection margin (hazard ratio [HR]: 1.54; 95%CI: 0.97–2.45) and lymphovascular invasion (LVI) (HR: 1.71; 95%CI: 1.09–2.69) were independent poor prognostic factors in the resected cohort. Conclusion Patients with PHC who underwent a resection for LN+ disease had better OS than patients who did not undergo resection because of locally advanced disease at exploratory laparotomy. LN+ PHC does not preclude 5-year survival after resection.
UR - http://www.scopus.com/inward/record.url?scp=85019648896&partnerID=8YFLogxK
U2 - 10.1016/j.hpb.2017.04.014
DO - 10.1016/j.hpb.2017.04.014
M3 - Article
C2 - 28549744
AN - SCOPUS:85019648896
SN - 1365-182X
VL - 19
SP - 735
EP - 740
JO - HPB
JF - HPB
IS - 8
ER -