Ruzzenente, Andrea, Bagante, Fabio 
ORCID: 0000-0002-5386-0958, Olthof, Pim B, Aldrighetti, Luca ORCID: 0000-0001-7729-2468, Alikhanov, Ruslan, Cescon, Matteo ORCID: 0000-0003-1715-3794, Koerkamp, Bas Groot, Jarnagin, William R, Nadalin, Silvio, Pratschke, Johann et al (show 7 more authors)
(2021)
Surgery for Bismuth-Corlette Type 4 Perihilar Cholangiocarcinoma: Results from a Western Multicenter Collaborative Group.
Annals of surgical oncology, 28 (12).
pp. 7719-7729.
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Surgery for Bismuth-Corlette Type 4 Perihilar Cholangiocarcinoma Results from a Western Multicenter Collaborative Group.pdf - Open Access published version Download (361kB) | Preview |
Abstract
<h4>Background</h4>Although Bismuth-Corlette (BC) type 4 perihilar cholangiocarcinoma (pCCA) is no longer considered a contraindication for curative surgery, few data are available from Western series to indicate the outcomes for these patients. This study aimed to compare the short- and long-term outcomes for patients with BC type 4 versus BC types 2 and 3 pCCA undergoing surgical resection using a multi-institutional international database.<h4>Methods</h4>Uni- and multivariable analyses of patients undergoing surgery at 20 Western centers for BC types 2 and 3 pCCA and BC type 4 pCCA.<h4>Results</h4>Among 1138 pCCA patients included in the study, 826 (73%) had BC type 2 or 3 disease and 312 (27%) had type 4 disease. The two groups demonstrated significant differences in terms of clinicopathologic characteristics (i.e., portal vein embolization, extended hepatectomy, and positive margin). The incidence of severe complications was 46% for the BC types 2 and 3 patients and 51% for the BC type 4 patients (p = 0.1). Moreover, the 90-day mortality was 13% for the BC types 2 and 3 patients and 12% for the BC type 4 patients (p = 0.57). Lymph-node metastasis (N1; hazard-ratio [HR], 1.62), positive margins (R1; HR, 1.36), perineural invasion (HR, 1.53), and poor grade of differentiation (HR, 1.25) were predictors of survival (all p ≤0.004), but BC type was not associated with prognosis. Among the N0 and R0 patients, the 5-year overall survival was 43% for the patients with BC types 2 and 3 pCCA and 41% for those with BC type 4 pCCA (p = 0.60).<h4>Conclusions</h4>In this analysis of a large Western multi-institutional cohort, resection was shown to be an acceptable curative treatment option for selected patients with BC type 4 pCCA although a more technically challenging surgical approach was required.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Perihilar Cholangiocarcinoma Collaboration Group, Humans, Cholangiocarcinoma, Bile Duct Neoplasms, Bismuth, Hepatectomy, Retrospective Studies, Klatskin Tumor |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 04 Mar 2024 09:56 |
| Last Modified: | 04 Mar 2024 09:56 |
| DOI: | 10.1245/s10434-021-09905-z |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3179029 |
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