Surgical treatment of 56 patients with hilar cholangiocarcinoma in a single center

Objective To study the safety and efficacy of surgical treatment for hilar cholangiocarcinoma (HC). Methods We retrospectively analyzed the clinical data of 56 patients with HC who underwent resection at the Beijing YouAn Hospital, Capital Medical University, from January 2010 to July 2015. The patients were divided into two groups according to the types of operations: the minor hepatectomy group (n=12) and the major hepatectomy group (n=44). The postoperative complications, mortality and long-term survival rates were compared and the clinical data were analyzed using uni- and multivariate analyses to examine the significant factors of survival. Results (1) The morbidity rates of the two groups were 33.3% and 63.6%, respectively, with the latter group being significantly higher than the former group; (2) The 1-and 3-year overall survival rates were 60% and 15% in the minor liver resection group and 64% and 15% in the major resection group, and there was no significant difference between the two groups (P>0.05). The median survival was 16 months; (3) The median survival of R0 resection was significantly longer than the R1/R2 resection group (22 months vs 10 months, P<0.05); (4) Age, preoperative CA19-9 level, vascular invasion, surgical margin, tumor differentiation and nodular metastasis were significantly correlated with prognosis on univariate analysis. Multivariate analysis showed surgical margin and tumor differentiation to be significant prognostic factors. Conclusions R0 resection obviously prolonged survival of HC patients, and histopathology negative surgical margin should be emphasized. With R0 resection, minor liver resection significantly reduced postoperative complications and mortality in selected patients. Key words: Hilar cholangiocarcinoma; Minor hepatectomy; Postoperative complications; Resection; Survival rate