Liver transplantation for peripheral cholangiocarcinoma: Spanish experience.
BACKGROUND
Palliative treatment for nondisseminated unresectable peripheral cholangiocarcinoma (PCC) carries a 0% 5-year survival rate. The role of orthotopic liver transplantation (OLT) in these patients is controversial because the survival rate is lower than with other indications for transplantation and the lack of available donor organs. The aim of this paper was to review the Spanish experience in OLT for PCC to identify prognostic factors for survival.


METHODS
We retrospectively reviewed 23 patients undergoing OLT in Spain for PCC over a period of 13 years.


RESULTS
The actuarial survival rates were 77%, 65%, and 42% at 1, 3, and 5 years, respectively. The main cause of death was tumor recurrence (35%). Prognotic factors for an adverse outcome were pTNM classification (P<.05) in the univariate analysis and perineural invasion (P<.05) and stages III or IVA (P<.05) in the multivariate analysis.


CONCLUSIONS
OLT for nondisseminated irresectable PCC displays higher survival rates at 3 and 5 years than palliative treatments, especially for tumors in the initial stages, which means that more information is needed to help better select PCC patients for transplantation.
Robles
R
R
Virgen de la Arrixaca University Hospital, Murcia, Spain. rirocam@um.es
Figueras
J
J
Turrión
V S
VS
Margarit
C
C
Moya
A
A
Varo
E
E
Calleja
J
J
Valdivieso
A
A
Garcia-Valdelcasas
J C
JC
López
P
P
Gómez
M
M
de Vicente
E
E
Loinaz
C
C
Santoyo
J
J
Fleiras
M
M
Bernardos
A
A
Marín
C
C
Fernández
J A
JA
Jaurrieta
E
E
Parrilla
P
P
D001650:Bile Duct Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic; D018281:Cholangiocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D016031:Liver Transplantation; D009362:Neoplasm Metastasis; D010166:Palliative Care; D012008:Recurrence; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors