The impact of portal vein resection on outcomes for hilar cholangiocarcinoma: A multi-institutional analysis of 305 cases

Mechteld C. De Jong, Hugo Marques, Bryan M. Clary, Todd W. Bauer, J. Wallis Marsh, Dario Ribero, Pietro Majno, Ioannis Hatzaras, Dustin M. Walters, Andrew S. Barbas, Raquel Mega, Richard D. Schulick, Michael A. Choti, David A. Geller, Eduardo Barroso, Gilles Mentha, Lorenzo Capussotti, Timothy M. Pawlik

Research output: Contribution to journalArticle

102 Citations (Scopus)

Abstract

BACKGROUND. Surgical strategy for hilar cholangiocarcinoma often includes hepatectomy, but the role of portal vein resection (PVR) remains controversial. In this study, the authors sought to identify factors associated with outcome after surgical management of hilar cholangiocarcinoma and examined the impact of PVR on survival. METHODS: Three hundred five patients who underwent curative-intent surgery for hilar cholangiocarcinoma between 1984 and 2010 were identified from an international, multi-institutional database. Clinicopathologic data were evaluated using univariate and multivariate analyses. RESULTS: Most patients had hilar cholangiocarcinoma with tumors classified as T3/T4 (51.1%) and Bismuth-Corlette type II/III (60.9%). Resection involved extrahepatic bile duct resection (EHBR) alone (26.6%); or hepatectomy and EHBR without PVR (56.7%); or combined hepatectomy, EHBR, and PVR (16.7%). Negative resection (R0) margin status was higher among the patients who underwent hepatectomy plus EHBR (without PVR, 64.2%; with PVR, 66.7%) versus EHBR alone (54.3%; P

Original languageEnglish
Pages (from-to)4737-4747
Number of pages11
JournalCancer
Volume118
Issue number19
DOIs
Publication statusPublished - Oct 1 2012

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Klatskin Tumor
Extrahepatic Bile Ducts
Portal Vein
Hepatectomy
Bismuth
Multivariate Analysis
Databases
Survival

Keywords

  • cholangiocarcinoma
  • hilar
  • outcome
  • portal vein

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

De Jong, M. C., Marques, H., Clary, B. M., Bauer, T. W., Marsh, J. W., Ribero, D., ... Pawlik, T. M. (2012). The impact of portal vein resection on outcomes for hilar cholangiocarcinoma: A multi-institutional analysis of 305 cases. Cancer, 118(19), 4737-4747. https://doi.org/10.1002/cncr.27492

The impact of portal vein resection on outcomes for hilar cholangiocarcinoma : A multi-institutional analysis of 305 cases. / De Jong, Mechteld C.; Marques, Hugo; Clary, Bryan M.; Bauer, Todd W.; Marsh, J. Wallis; Ribero, Dario; Majno, Pietro; Hatzaras, Ioannis; Walters, Dustin M.; Barbas, Andrew S.; Mega, Raquel; Schulick, Richard D.; Choti, Michael A.; Geller, David A.; Barroso, Eduardo; Mentha, Gilles; Capussotti, Lorenzo; Pawlik, Timothy M.

In: Cancer, Vol. 118, No. 19, 01.10.2012, p. 4737-4747.

Research output: Contribution to journalArticle

De Jong, MC, Marques, H, Clary, BM, Bauer, TW, Marsh, JW, Ribero, D, Majno, P, Hatzaras, I, Walters, DM, Barbas, AS, Mega, R, Schulick, RD, Choti, MA, Geller, DA, Barroso, E, Mentha, G, Capussotti, L & Pawlik, TM 2012, 'The impact of portal vein resection on outcomes for hilar cholangiocarcinoma: A multi-institutional analysis of 305 cases', Cancer, vol. 118, no. 19, pp. 4737-4747. https://doi.org/10.1002/cncr.27492
De Jong, Mechteld C. ; Marques, Hugo ; Clary, Bryan M. ; Bauer, Todd W. ; Marsh, J. Wallis ; Ribero, Dario ; Majno, Pietro ; Hatzaras, Ioannis ; Walters, Dustin M. ; Barbas, Andrew S. ; Mega, Raquel ; Schulick, Richard D. ; Choti, Michael A. ; Geller, David A. ; Barroso, Eduardo ; Mentha, Gilles ; Capussotti, Lorenzo ; Pawlik, Timothy M. / The impact of portal vein resection on outcomes for hilar cholangiocarcinoma : A multi-institutional analysis of 305 cases. In: Cancer. 2012 ; Vol. 118, No. 19. pp. 4737-4747.
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abstract = "BACKGROUND. Surgical strategy for hilar cholangiocarcinoma often includes hepatectomy, but the role of portal vein resection (PVR) remains controversial. In this study, the authors sought to identify factors associated with outcome after surgical management of hilar cholangiocarcinoma and examined the impact of PVR on survival. METHODS: Three hundred five patients who underwent curative-intent surgery for hilar cholangiocarcinoma between 1984 and 2010 were identified from an international, multi-institutional database. Clinicopathologic data were evaluated using univariate and multivariate analyses. RESULTS: Most patients had hilar cholangiocarcinoma with tumors classified as T3/T4 (51.1{\%}) and Bismuth-Corlette type II/III (60.9{\%}). Resection involved extrahepatic bile duct resection (EHBR) alone (26.6{\%}); or hepatectomy and EHBR without PVR (56.7{\%}); or combined hepatectomy, EHBR, and PVR (16.7{\%}). Negative resection (R0) margin status was higher among the patients who underwent hepatectomy plus EHBR (without PVR, 64.2{\%}; with PVR, 66.7{\%}) versus EHBR alone (54.3{\%}; P",
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