Analysis of Survival and Factors Affecting the Survival after Surgical Resection of Peripheral Cholangiocarcinoma: 318 Cases in Single Institute

Korean J Hepatol > Volume 13(2); 2007 > Article

The Korean Journal of Hepatology 2007;13(2): 208-221.

Analysis of Survival and Factors Affecting the Survival after Surgical Resection of Peripheral Cholangiocarcinoma: 318 Cases in Single Institute

Gi Won Song , Sung Gyu Lee , Young Joo Lee , Kwang Min Park , Shin Hwang , Ki Hun Kim , Chul Soo Ahn , Deok Bog Moon , Tae Yong Ha , Dong Hwan Jung

Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

ABSTRACT

Backgrounds/Aims
Although the survival rate after surgical resection of peripheral cholangiocarcinoma is low, surgical resection is only potentially curative therapy. The aim of this study is to evaluate clinicopathological factors affecting survival after surgical resection of peripheral cholangiocarcinoma. Methods: Between February 1990 and December 2005, surgical intervention with curative intent was performed on 318 patients and 292 patients underwent resection. We retrospectively analyzed survival data of 318 patients and clinicopathological factors affecting survival by reviewing the medical record. Results: Among the 292 cases of resection, curative resection with tumor-free margin (R0) has been resulted in 221 cases. The 1-, 3-, 5- and 10-year survival rate of R0 resection were 74.9, 46.9, 36.9 and 15.2%, respectively. The survival rate of patient undergoing R0 resection was significantly better than that of R1, R2 or nonresection. Multivariate analysis showed that curative resectability, macroscopic type of tumor and lymph node metastasis were statically significant independent prognostic factors. Conclusions: The survival after surgical resection of peripheral cholangiocarcinoma depends on curability of surgical resection, macroscopic type of tumor and status of lymph node. Particullary in R0 resection for intraductal growth type without lymph node metastasis, there is great chance for long-term survival. Surgical resection attaining tumor free margin should be attempted if liver function and general condition of patient are acceptable for hepatectomy. (Korean J Hepatol 2007;13:208-221)

KeyWords: Cholangiocarcinoma; Surgery; Survival; Treatment outcome; Prognosis