Liver resection for hilar cholangiocarcinoma: in-hospital mortality and longterm survival
Extended surgical procedures are the only chance of longterm survival for patients with Klatskin tumors, but high mortality rates have been reported. The type of treatment for Bismuth type I–II carcinomas is still a matter of discussion. We performed a single-unit, retrospective study analyzing 36 p...
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| Veröffentlicht in: | Journal of the American College of Surgeons 2002-11, Vol.195 (5), p.641-647 |
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| creator | Capussotti, Lorenzo Muratore, Andrea Polastri, Roberto Ferrero, Alessandro Massucco, Paolo |
| description | Extended surgical procedures are the only chance of longterm survival for patients with Klatskin tumors, but high mortality rates have been reported. The type of treatment for Bismuth type I–II carcinomas is still a matter of discussion.
We performed a single-unit, retrospective study analyzing 36 patients who underwent resectional surgery for Klatskin tumor.
An associated liver resection was performed in 88.9% of our patients; most of them had a major hepatectomy. The in-hospital mortality rate was 2.8%. Three- and 5-year survival rates were 40.8% and 27.2%, respectively. But the group of patients with Bismuth type I–II carcinomas undergoing hepatectomy had markedly better longterm outcomes than those undergoing hilar resection (p = 0.04): 54.5% versus 0% at 5 years, respectively; none of the patients who had only resection of bile duct confluence were alive at 2 years. Lymph node metastases were found in 38.8% of our patients; nodal involvement was not a major prognostic factor.
Achievement of low in-hospital mortality rates is possible in specialized surgical departments. Aggressive surgical approaches can allow better longterm results in the subset of Bismuth type I–II carcinomas. |
| doi_str_mv | 10.1016/S1072-7515(02)01481-3 |
| format | Article |
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We performed a single-unit, retrospective study analyzing 36 patients who underwent resectional surgery for Klatskin tumor.
An associated liver resection was performed in 88.9% of our patients; most of them had a major hepatectomy. The in-hospital mortality rate was 2.8%. Three- and 5-year survival rates were 40.8% and 27.2%, respectively. But the group of patients with Bismuth type I–II carcinomas undergoing hepatectomy had markedly better longterm outcomes than those undergoing hilar resection (p = 0.04): 54.5% versus 0% at 5 years, respectively; none of the patients who had only resection of bile duct confluence were alive at 2 years. Lymph node metastases were found in 38.8% of our patients; nodal involvement was not a major prognostic factor.
Achievement of low in-hospital mortality rates is possible in specialized surgical departments. Aggressive surgical approaches can allow better longterm results in the subset of Bismuth type I–II carcinomas.</description><identifier>ISSN: 1072-7515</identifier><identifier>EISSN: 1879-1190</identifier><identifier>DOI: 10.1016/S1072-7515(02)01481-3</identifier><identifier>PMID: 12437251</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Aged ; Bile Duct Neoplasms - mortality ; Bile Duct Neoplasms - surgery ; Bile Ducts - surgery ; Biliary Tract Surgical Procedures - methods ; Biliary Tract Surgical Procedures - mortality ; Biological and medical sciences ; Cholangiocarcinoma - mortality ; Cholangiocarcinoma - surgery ; Female ; Hepatectomy - methods ; Hepatectomy - mortality ; Hospital Mortality ; Humans ; Klatskin Tumor - mortality ; Klatskin Tumor - surgery ; Liver, biliary tract, pancreas, portal circulation, spleen ; Male ; Medical sciences ; Middle Aged ; Retrospective Studies ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the digestive system ; Survival Analysis ; Time Factors ; Treatment Outcome</subject><ispartof>Journal of the American College of Surgeons, 2002-11, Vol.195 (5), p.641-647</ispartof><rights>2002 American College of Surgeons</rights><rights>2003 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c457t-7d7a2a17f89a33a3bae10bb759c55088c25208032389c70da356c4c7922c783b3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S1072-7515(02)01481-3$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,777,781,3537,27905,27906,45976,69992</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=14021385$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12437251$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Capussotti, Lorenzo</creatorcontrib><creatorcontrib>Muratore, Andrea</creatorcontrib><creatorcontrib>Polastri, Roberto</creatorcontrib><creatorcontrib>Ferrero, Alessandro</creatorcontrib><creatorcontrib>Massucco, Paolo</creatorcontrib><title>Liver resection for hilar cholangiocarcinoma: in-hospital mortality and longterm survival</title><title>Journal of the American College of Surgeons</title><addtitle>J Am Coll Surg</addtitle><description>Extended surgical procedures are the only chance of longterm survival for patients with Klatskin tumors, but high mortality rates have been reported. The type of treatment for Bismuth type I–II carcinomas is still a matter of discussion.
We performed a single-unit, retrospective study analyzing 36 patients who underwent resectional surgery for Klatskin tumor.
An associated liver resection was performed in 88.9% of our patients; most of them had a major hepatectomy. The in-hospital mortality rate was 2.8%. Three- and 5-year survival rates were 40.8% and 27.2%, respectively. But the group of patients with Bismuth type I–II carcinomas undergoing hepatectomy had markedly better longterm outcomes than those undergoing hilar resection (p = 0.04): 54.5% versus 0% at 5 years, respectively; none of the patients who had only resection of bile duct confluence were alive at 2 years. Lymph node metastases were found in 38.8% of our patients; nodal involvement was not a major prognostic factor.
Achievement of low in-hospital mortality rates is possible in specialized surgical departments. Aggressive surgical approaches can allow better longterm results in the subset of Bismuth type I–II carcinomas.</description><subject>Aged</subject><subject>Bile Duct Neoplasms - mortality</subject><subject>Bile Duct Neoplasms - surgery</subject><subject>Bile Ducts - surgery</subject><subject>Biliary Tract Surgical Procedures - methods</subject><subject>Biliary Tract Surgical Procedures - mortality</subject><subject>Biological and medical sciences</subject><subject>Cholangiocarcinoma - mortality</subject><subject>Cholangiocarcinoma - surgery</subject><subject>Female</subject><subject>Hepatectomy - methods</subject><subject>Hepatectomy - mortality</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Klatskin Tumor - mortality</subject><subject>Klatskin Tumor - surgery</subject><subject>Liver, biliary tract, pancreas, portal circulation, spleen</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Retrospective Studies</subject><subject>Surgery (general aspects). 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Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the digestive system</topic><topic>Survival Analysis</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Capussotti, Lorenzo</creatorcontrib><creatorcontrib>Muratore, Andrea</creatorcontrib><creatorcontrib>Polastri, Roberto</creatorcontrib><creatorcontrib>Ferrero, Alessandro</creatorcontrib><creatorcontrib>Massucco, Paolo</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American College of Surgeons</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Capussotti, Lorenzo</au><au>Muratore, Andrea</au><au>Polastri, Roberto</au><au>Ferrero, Alessandro</au><au>Massucco, Paolo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Liver resection for hilar cholangiocarcinoma: in-hospital mortality and longterm survival</atitle><jtitle>Journal of the American College of Surgeons</jtitle><addtitle>J Am Coll Surg</addtitle><date>2002-11-01</date><risdate>2002</risdate><volume>195</volume><issue>5</issue><spage>641</spage><epage>647</epage><pages>641-647</pages><issn>1072-7515</issn><eissn>1879-1190</eissn><abstract>Extended surgical procedures are the only chance of longterm survival for patients with Klatskin tumors, but high mortality rates have been reported. The type of treatment for Bismuth type I–II carcinomas is still a matter of discussion.
We performed a single-unit, retrospective study analyzing 36 patients who underwent resectional surgery for Klatskin tumor.
An associated liver resection was performed in 88.9% of our patients; most of them had a major hepatectomy. The in-hospital mortality rate was 2.8%. Three- and 5-year survival rates were 40.8% and 27.2%, respectively. But the group of patients with Bismuth type I–II carcinomas undergoing hepatectomy had markedly better longterm outcomes than those undergoing hilar resection (p = 0.04): 54.5% versus 0% at 5 years, respectively; none of the patients who had only resection of bile duct confluence were alive at 2 years. Lymph node metastases were found in 38.8% of our patients; nodal involvement was not a major prognostic factor.
Achievement of low in-hospital mortality rates is possible in specialized surgical departments. Aggressive surgical approaches can allow better longterm results in the subset of Bismuth type I–II carcinomas.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>12437251</pmid><doi>10.1016/S1072-7515(02)01481-3</doi><tpages>7</tpages></addata></record> |
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| subjects | Aged Bile Duct Neoplasms - mortality Bile Duct Neoplasms - surgery Bile Ducts - surgery Biliary Tract Surgical Procedures - methods Biliary Tract Surgical Procedures - mortality Biological and medical sciences Cholangiocarcinoma - mortality Cholangiocarcinoma - surgery Female Hepatectomy - methods Hepatectomy - mortality Hospital Mortality Humans Klatskin Tumor - mortality Klatskin Tumor - surgery Liver, biliary tract, pancreas, portal circulation, spleen Male Medical sciences Middle Aged Retrospective Studies Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the digestive system Survival Analysis Time Factors Treatment Outcome |
| title | Liver resection for hilar cholangiocarcinoma: in-hospital mortality and longterm survival |
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