Our experiences in surgical treatment for hilar cholangiocarcinoma.
OBJECTIVE
Although resection for hilar cholangiocarcinoma usually requires difficult surgical manipulations, it is only one therapeutic modality for a permanent cure or a desirable prognosis. We verified our own experiences after surgical treatment for hilar cholangiocarcinoma.


METHODS
This study included 24 patients with hilar cholangiocarcinoma from 1981 to 2002. The current study mainly evaluated postoperative complications and overall prognosis after resection.


RESULTS
Twenty-one patients received tumor resection. Hepatic resection including extended hepatectomy was required in 19 patients (90.5%). Postoperative morbidity was observed in 16 (71.2%), and motality in 2 (9.5%). The overall 5-year survival rate was 33.7%, and median survival was 35.7 months. Tumor extent in the TNM stage (p = 0.011) and the existence of lymph node metastases (p = 0.038) were identified as significant prognostic factors in overall survival after operation by univariate analysis. Postoperative adjuvant radio-chemotherapy after resection improved their prognosis (p = 0.010).


CONCLUSIONS
Our results suggest that aggressive resection and appropriate adjuvant therapies for hilar cholangiocarcinoma might make a better prognosis possible, especially in patients without lymph node metastases excluding advanced tumor.
Maeno
Hiroshi
H
Department of Digestive and General Surgery, School of Medicine, Shimane University, Izumo 693-8501, Japan. hm7777@io.ocn.ne.jp
Ono
Takashi
T
Yamanoi
Akira
A
Nagasue
Naofumi
N
D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000401:mortality / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D018281:Cholangiocarcinoma / Q000401:mortality / Q000601:surgery*; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome