title: [Malignant tumors of the hepatic bifurcation--results of surgical therapy and prognostic factors].
abstract: Between 1 January 1986 and 31 December 1994, 45 patients with carcinoma of the hepatic bifurcation underwent operations in the department of surgery. According to Bismuth's classification (1992), there were 7 type I, 4 type II, 22 type III and 12 type IV tumors. 31 of the 45 patients (68.9%) underwent surgical resections with curative intentions: resection of the hepatic bifurcation (n = 9, 29%), resection of the hepatic bifurcation with hilar liver resection (n = 7, 22.6%), resection of the hepatic bifurcation with left hemihepatectomy (n = 10, 32.3%), orthotopic liver transplantation (n = 5, 16.1%). The remaining 14 patients underwent palliative (n = 6) or diagnostic (n = 8) operations. Two of the 45 patients (4.2%) died in hospital. Histological examination demonstrated R0 resection in 17 of 31 (54.8%) of the patients, while in the remaining 14 cases, only a R1/RX resection had been achieved. One-, 2- and 5-year survival rates were 75.4%, 53.9% and 24.5% (median survival: 729 days) in the 31 resected patients, and 30.8%, 10.3% and 0% (median survival: 153 days) in the palliative treatment group. A statistically significant influence on survival could be demonstrated for nodal status (N0/N1) and residual tumor status (R0/R1, R2).
authors.affiliation: Chirurgische Klinik und Poliklinik, Technischen Universität München, Klinikum Rechts der Isar.
authors.forename: K T
authors.initials: KT
authors.lastname: Beckurts
authors.forename: A H
authors.initials: AH
authors.lastname: Hölscher
authors.forename: T H
authors.initials: TH
authors.lastname: Bauer
authors.forename: J R
authors.initials: JR
authors.lastname: Siewert
mesh_terms: D000328:Adult; D000368:Aged; D001650:Bile Duct Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D001651:Cholestasis, Extrahepatic / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods*; D006500:Hepatic Duct, Common / Q000473:pathology / Q000601:surgery*; D006801:Humans; D018285:Klatskin Tumor / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000401:mortality; D015996:Survival Rate; D016896:Treatment Outcome