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SHR Neuro Cancer Cardio Lipid Metab Microb

Hoffmann, K; Luible, S; Goeppert, B; Weiss, KH; Hinz, U; Büchler, MW; Schemmer, P.
Impact of portal vein resection on oncologic long-term outcome in patients with hilar cholangiocarcinoma.
Surgery. 2015; 158(5):1252-1260 Doi: 10.1016/j.surg.2015.04.032
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Co-authors Med Uni Graz: Schemmer Peter
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Abstract:: Liver resection (LR) for hilar cholangiocarcinoma (HCA) remains challenging because of the occurrence of unanticipated vascular and longitudinal bile duct invasion. Operative strategies to achieve negative resection margins vary, and the benefit of routine portal vein resection (PVR) is discussed controversially. The data of 60 consecutive patients who underwent LR for HCA were analyzed. Twenty-one patients (35.0%) underwent LR plus PVR and 39 (65.0%) LR only. Clinicopathologic data were evaluated by the use of uni- and multivariate analyses. The majority of resections was performed for Bismuth-Corlette type III/IV tumors (97.3%). Hepatectomy involved trisectionectomies in 41 patients (68.3%). R1 resection margin status was identified as adverse prognosis factor for survival (hazard ratio 3.61; P = .003). PVR increased the perioperative morbidity (P = .04). The 90-day mortality rate was comparable between both groups (P = .70). Negative resection margin status was similar between groups (P = .70). The lymph node clearance was equal (P = .86). PVR was not associated with a beneficial long-term outcome, the 5-year and disease-free survival were comparable (LR only 17.8% vs LR plus PVR 20.0% [P = .89] and LR only 10.6% vs LR plus PVR 21.4% [P = .63]). PVR was no prognostic factor for tumor-dependent or disease-free survival (hazard ratio 0.64; P = .26 and hazard ratio 0.76; P = .47). The presented data indicate that simultaneous PVR has no beneficial impact on oncologic long-term outcome in patients undergoing LR for HCA. Because it increases the perioperative morbidity, a recommendation for routine application cannot be given. Copyright © 2015 Elsevier Inc. All rights reserved.
Find related publications in this database (using NLM MeSH Indexing): Adult -; Aged -; Bile Duct Neoplasms - mortality; Bile Duct Neoplasms - pathology; Bile Duct Neoplasms - surgery; Cohort Studies -; Disease-Free Survival -; Female -; Hepatectomy -; Humans -; Klatskin Tumor - mortality; Klatskin Tumor - pathology; Klatskin Tumor - surgery; Male -; Middle Aged -; Portal Vein - surgery; Survival Rate -; Treatment Outcome -