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. 2021 Mar;28(3):1483-1492.
doi: 10.1245/s10434-020-09001-8. Epub 2020 Sep 8.

Eligibility for Liver Transplantation in Patients with Perihilar Cholangiocarcinoma

Jaynee J A Vugts  1 , Marcia P Gaspersz  1 , Eva Roos  2 , Lotte C Franken  2 , Pim B Olthof  2 , Robert J S Coelen  2 , Jeroen L A van Vugt  1 , Tim A Labeur  2 , Lieke Brouwer  3 , Marc G H Besselink  2 , Jan N M IJzermans  1 , Sarwa Darwish Murad  4 , Thomas M van Gulik  2 , Jeroen de Jonge  1 , Wojciech G Polak  1 , Olivier R C Busch  2 , Joris L Erdmann  2 , Bas Groot Koerkamp #  5 , Stefan Buettner #  6
Affiliations

Eligibility for Liver Transplantation in Patients with Perihilar Cholangiocarcinoma

Jaynee J A Vugts et al. Ann Surg Oncol. 2021 Mar.

Erratum in

Abstract

Background: Liver transplantation (LT) has been performed in a select group of patients presenting with unresectable or primary sclerosing cholangitis (PSC)-associated perihilar cholangiocarcinoma (pCCA) in the Mayo Clinic with a reported 5-year overall survival (OS) of 53% on intention-to-treat analysis. The objective of this study was to estimate eligibility for LT in a cohort of pCCA patients in two tertiary referral centers.

Methods: Patients diagnosed with pCCA between 2002 and 2014 were included from two tertiary referral centers in the Netherlands. The selection criteria used by the Mayo Clinic were retrospectively applied to determine the proportion of patients that would have been eligible for LT.

Results: A total of 732 consecutive patients with pCCA were identified, of whom 24 (4%) had PSC-associated pCCA. Overall, 154 patients had resectable disease on imaging and 335 patients were ineligible for LT because of lymph node or distant metastases. An age limit of 70 years led to the exclusion of 50 patients who would otherwise be eligible for LT. After applying the Mayo Clinic criteria, only 34 patients (5%) were potentially eligible for LT. Median survival from diagnosis for these 34 patients was 13 months (95% CI 3-23).

Conclusion: Only 5% of all patients presenting with pCCA were potentially eligible for LT under the Mayo criteria. Without transplantation, a median OS of about 1 year was observed.

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Figures

Fig. 1
Fig. 1
Liver transplantation eligibility. For nodal and distant metastases, suspicion based on imaging and suspicion/confirmation based on laparoscopy/laparotomy were pooled
Fig. 2
Fig. 2
Overall survival
See this image and copyright information in PMC

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