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Multicenter Study
. 2021 Nov;23(11):1751-1758.
doi: 10.1016/j.hpb.2021.04.011. Epub 2021 Apr 28.

Outcome after resection for perihilar cholangiocarcinoma in patients with primary sclerosing cholangitis: an international multicentre study

Hannes Jansson  1 , Pim B Olthof  2 , Annika Bergquist  3 , Marjolein A P Ligthart  4 , Silvio Nadalin  5 , Roberto I Troisi  6 , Bas Groot Koerkamp  7 , Ruslan Alikhanov  8 , Hauke Lang  9 , Alfredo Guglielmi  10 , Matteo Cescon  11 , William R Jarnagin  12 , Luca Aldrighetti  13 , Thomas M van Gulik  2 , Ernesto Sparrelid  14 ; Perihilar Cholangiocarcinoma Collaboration Group
Collaborators, Affiliations
Multicenter Study

Outcome after resection for perihilar cholangiocarcinoma in patients with primary sclerosing cholangitis: an international multicentre study

Hannes Jansson et al. HPB (Oxford). 2021 Nov.

Abstract

Background: Resection for perihilar cholangiocarcinoma (pCCA) in primary sclerosing cholangitis (PSC) has been reported to lead to worse outcomes than resection for non-PSC pCCA. The aim of this study was to compare prognostic factors and outcomes after resection in patients with PSC-associated pCCA and non-PSC pCCA.

Methods: The international retrospective cohort comprised patients resected for pCCA from 21 centres (2000-2020). Patients operated with hepatobiliary resection, with pCCA verified by histology and with data on PSC status, were included. The primary outcome was overall survival. Secondary outcomes were disease-free survival and postoperative complications.

Results: Of 1128 pCCA patients, 34 (3.0%) had underlying PSC. Median overall survival after resection was 33 months for PSC patients and 29 months for non-PSC patients (p = .630). Complications (Clavien-Dindo grade ≥ 3) were more frequent in PSC pCCA (71% versus 44%, p = .003). The rate of posthepatectomy liver failure (21% versus 17%, p = .530) and 90-day mortality (12% versus 13%, p = 1.000) was similar for PSC and non-PSC patients.

Conclusion: Median overall survival after resection for pCCA was similar in patients with underlying PSC and non-PSC patients. Complications were more frequent after resection for PSC-associated pCCA, with no difference in postoperative mortality.

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Conflict of interest statement

Conflicts of interest

None declared.

Figures

Figure 1
Figure 1
Study flow chart illustrating the study population. PSC: Primary sclerosing cholangitis; pCCA: perihilar cholangiocarcinoma
Figure 2
Figure 2
Overall survival (panel A) and disease-free survival (panel B) in PSC pCCA patients (blue) compared to non-PSC pCCA patients (red). Kaplan–Meier estimates with 95% confidence intervals (shaded bands). Time in months. Survival curves compared using the log-rank test. pCCA: perihilar cholangiocarcinoma; PSC: primary sclerosing cholangitis
See this image and copyright information in PMC

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