Survival after resection of perihilar cholangiocarcinoma in patients with lymph node metastases. Issue 8 (August 2017)

• Record Type: Journal Article
• Authors: Buettner, Stefan; van Vugt, Jeroen L.A.; Gaspersz, Marcia P.; Coelen, Robert J.S.; Roos, Eva; Labeur, Tim A.; Margonis, Georgios A.; Ethun, Cecilia G.; Maithel, Shishir K.; Poultsides, George; Tran, Thuy; Idrees, Kamran; Isom, Chelsea A.; Fields, Ryan C.; Krasnick, Bradley A.; Weber, Sharon M.; Salem, Ahmed; Martin, Robert C.G.; Scoggins, Charles R.; Shen, Perry; Mogal, Harveshp D.; Schmidt, Carl; Beal, Eliza; Hatzaras, Ioannis; Shenoy, Rivfka; IJzermans, Jan N.M.; van Gulik, Thomas M.; Pawlik, Timothy M.; Groot Koerkamp, Bas
• Is Part Of: HPB. Volume 19:Issue 8(2017)
• Page Start: 735
• Page End: 740
• Publication Date: 2017-08
• Subjects: Liver -- Diseases -- Periodicals; Biliary tract -- Diseases -- Periodicals; Pancreas -- Diseases -- Periodicals; 616.362005
• DOI: 10.1016/j.hpb.2017.04.014
• Languages: English
• ISSNs: 1365-182X

Abstract

Abstract: 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.