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Comparative Study
. 2017 Aug;19(8):735-740.
doi: 10.1016/j.hpb.2017.04.014. Epub 2017 May 23.

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

Stefan Buettner  1 , Jeroen L A van Vugt  2 , Marcia P Gaspersz  2 , Robert J S Coelen  3 , Eva Roos  3 , Tim A Labeur  3 , Georgios A Margonis  4 , Cecilia G Ethun  5 , Shishir K Maithel  5 , George Poultsides  6 , Thuy Tran  6 , Kamran Idrees  7 , Chelsea A Isom  7 , Ryan C Fields  8 , Bradley A Krasnick  8 , Sharon M Weber  9 , Ahmed Salem  9 , Robert C G Martin  10 , Charles R Scoggins  10 , Perry Shen  11 , Harveshp D Mogal  11 , Carl Schmidt  12 , Eliza Beal  12 , Ioannis Hatzaras  13 , Rivfka Shenoy  13 , Jan N M IJzermans  2 , Thomas M van Gulik  3 , Timothy M Pawlik  4 , Bas Groot Koerkamp  14
Affiliations
Comparative Study

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

Stefan Buettner et al. HPB (Oxford). 2017 Aug.

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.

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Conflict of interest statement

Funds/conflict of interest: none

Figures

Figure 1
Figure 1
Overall survival stratified for treatment group (p < 0.001)
Figure 2
Figure 2
Overall Survival of Resected R1 Patients versus Non-Resected Patients (p = 0.086)
Figure 3
Figure 3
Overall Survival of Resected Lymphovascular Invasion Patients versus Non-Resected Patients (p = 0.073)
See this image and copyright information in PMC

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