[Proximal bile duct cholangiocarcinomas].
OBJECTIVE
The aim of this retrospective study was to report a series of 12 patients with hilar cholangiocarcinoma treated by curative resection.


METHODS
Between 1980 and 1998, curative resection was performed in 12 patients out of 33 patients with a Klatskin's tumor. Preoperative biliary drainage was performed in 6 cases. Resection was limited to the extrahepatic bile duct in one case only. Resection was extended to the liver in 11 cases including segmentectomy I (n = 9), left hepatectomy (n = 7), right hepatectomy (n = 3) and segmentectomy IV (n = 1). Postoperative brachytherapy was performed in 3 patients combined with conventional radiotherapy. Conventional radiotherapy irradiation was performed in 2 patients and was associated with chemotherapy in 1 patient.


RESULTS
There was no postoperative mortality. Postoperative follow-up was uneventful in 5 patients. Actuarial survival rate at 1, 2, 3, and 5 years was 81, 57, 28 and 28%, respectively. Prolonged survivals (88 and 114 months) were observed.


CONCLUSIONS
Hilar cholangiocarcinomas have a poor prognosis. Curative resections are usually performed with major liver resections. RM cholangiography is now the most efficient examination for selection of surgical indications and choice of the best strategy. Long-term survival can be obtained with curative surgery. Adjuvant treatment has to be assessed by controlled trials.
Service de chirurgie digestive et de la transplantation hépatique, hôpital de la Croix-Rousse, 103, grande rue de la Croix-Rousse, 69317 Lyon, France.
M C
MC
Blanchet
C
C
Ducerf
L
L
Benoit
J P
JP
Gérard
J
J
Baulieux
D000206:Actuarial Analysis; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001650:Bile Duct Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D001918:Brachytherapy; D018281:Cholangiocarcinoma / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D002758:Cholangiography; D003131:Combined Modality Therapy; D005260:Female; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
D000970:Antineoplastic Agents