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Survival after resection of perihilar cholangiocarcinoma in patients with lymph node metastases.

Buettner S, van Vugt JLA, Gaspersz MP, Coelen RJS, Roos E, Labeur TA, Margonis GA, Ethun CG, Maithel SK, Poultsides G, Tran T, Idrees K, Isom CA, Fields RC, Krasnick BA, Weber SM, Salem A, Martin RCG, Scoggins CR, Shen P, Mogal HD, Schmidt C, Beal E, Hatzaras I, Shenoy R, IJzermans JNM, van Gulik TM, Pawlik TM, Groot Koerkamp B
HPB (Oxford). 2017 19 (8): 735-740

PMID: 28549744 · PMCID: PMC5907486 · DOI:10.1016/j.hpb.2017.04.014

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.

Copyright © 2017 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.

MeSH Terms (19)

Aged Bile Duct Neoplasms Chemotherapy, Adjuvant Female Hepatectomy Humans Kaplan-Meier Estimate Klatskin Tumor Lymphatic Metastasis Male Middle Aged Netherlands Proportional Hazards Models Radiotherapy, Adjuvant Retrospective Studies Risk Factors Time Factors Treatment Outcome United States

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