title: Outcomes after resection of cholangiocellular carcinoma.
abstract: BACKGROUND
  Cholangiocellular carcinoma (CCC) is a rare primary liver malignancy that arises from intrahepatic bile duct canaliculi and presents as a liver mass. Our purpose is to report operative morbidity and mortality and to determine long-term survival after resection for CCC.
  
  
  METHODS
  Retrospective review of 31 consecutive patients who underwent resection during a 20-year period.
  
  
  RESULTS
  Thirty-day hospital mortality was 3%, and postoperative morbidity was 38%. Kaplan-Meier 5-year survival was 35%; mean survival was 37 months; absolute 5-year survival was 33%. Mean survival in stages I, II, IIIA, and IIIC were 57, 33, 26, and 14 months, respectively (P = 0.03 comparing I to >I). Recurrence occurred in 18 patients; 89% were in the liver. Carbohydrate antigen 19-9 >100 U/mL was found to be an indicator of poor prognosis (P = 0.009).
  
  
  CONCLUSIONS
  Resection for CCC can be performed with acceptable morbidity and mortality rates and results in good survival and cure. Hepatic recurrence is common. Carbohydrate antigen 19-9 may be useful in determining prognosis.
authors.affiliation: Department of General, Thoracic, and Vascular Surgery, Virginia Mason Medical Center, 1100 Ninth Ave., P.O. Box 900, M/S C6-SUR, Seattle, WA 98111 USA.
authors.forename: Jasmine L
authors.initials: JL
authors.lastname: Huang
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Biehl
authors.forename: Faye T
authors.initials: FT
authors.lastname: Lee
authors.forename: Peter W
authors.initials: PW
authors.lastname: Zimmer
authors.forename: John A
authors.initials: JA
authors.lastname: Ryan
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018395:CA-19-9 Antigen / Q000097:blood; D018281:Cholangiocarcinoma / Q000097:blood / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery*; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000379:methods / Q000401:mortality; D017052:Hospital Mortality; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D015999:Multivariate Analysis; D009325:Nausea / Q000209:etiology; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D009367:Neoplasm Staging; D018579:Patient Selection; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D018395:CA-19-9 Antigen