title: Liver transplantation for hilar cholangiocarcinoma: a German survey.
abstract: BACKGROUND
  The present study reports a German survey addressing outcomes in nonselected historical series of liver transplantation (OLT) for hilar cholangiocarcinoma (HL).
  
  
  METHODS
  We sent to all 25 German transplant centers performing OLT a survey that addressed (1) the number of OLTs for HL and the period during which they were performed; (2) the incidence of HL diagnosed prior to OLT/rate of incidental HL (for example, in primary sclerosing cholangitis); (3) tumor stages according to Union Internationale Centre le Cancer; (4) patient survival; and (5) tumor recurrence rate.
  
  
  RESULTS
  Eighty percent of centers responded, reporting 47 patients who were transplanted for HL. Tumors were classified as pT2 (25%), pT3 (73%), or pT4 (2%). HL was diagnosed incidentally in 10% of cases. A primary diagnosis of PSC was observed in 16% of patients. Overall median survival was 35.5 months. When in-hospital mortality (n = 12) was excluded, the median survival was 45.4 months, corresponding to 3- and 5-year survival rates of 42% and 31%, versus 31% and 22% when in-hospital mortality was included. HL recurred in 34% of cases. Three- and 5-year survivals for the 15 patients transplanted since 1998 was 57% and 48%, respectively. Median survival ranged from 20 to 42 months based on the time period (P = .014).
  
  
  CONCLUSIONS
  The acceptable overall survival, the improved results after careful patient selection since 1998, and the encouraging outcomes from recent studies all suggest that OLT may be a potential treatment for selected cases of HL. Prospective multicenter randomized studies with strict selection criteria and multimodal treatments seem necessary.
authors.affiliation: Klinik für Allgemein-, Viszeral und Transplantationschirurgie, Universitätsklinikum Essen, Germany.
authors.forename: G M
authors.initials: GM
authors.lastname: Kaiser
authors.forename: G C
authors.initials: GC
authors.lastname: Sotiropoulos
authors.forename: K W
authors.initials: KW
authors.lastname: Jauch
authors.forename: F
authors.initials: F
authors.lastname: Löhe
authors.forename: A
authors.initials: A
authors.lastname: Hirner
authors.forename: J C
authors.initials: JC
authors.lastname: Kalff
authors.forename: A
authors.initials: A
authors.lastname: Königsrainer
authors.forename: W
authors.initials: W
authors.lastname: Steurer
authors.forename: N
authors.initials: N
authors.lastname: Senninger
authors.forename: J G
authors.initials: JG
authors.lastname: Brockmann
authors.forename: H J
authors.initials: HJ
authors.lastname: Schlitt
authors.forename: C
authors.initials: C
authors.lastname: Zülke
authors.forename: M W
authors.initials: MW
authors.lastname: Büchler
authors.forename: P
authors.initials: P
authors.lastname: Schemmer
authors.forename: U
authors.initials: U
authors.lastname: Settmacher
authors.forename: J
authors.initials: J
authors.lastname: Hauss
authors.forename: H
authors.initials: H
authors.lastname: Lippert
authors.forename: U T
authors.initials: UT
authors.lastname: Hopt
authors.forename: G
authors.initials: G
authors.lastname: Otto
authors.forename: M M
authors.initials: MM
authors.lastname: Heiss
authors.forename: W O
authors.initials: WO
authors.lastname: Bechstein
authors.forename: S
authors.initials: S
authors.lastname: Timm
authors.forename: E
authors.initials: E
authors.lastname: Klar
authors.forename: A H
authors.initials: AH
authors.lastname: Hölscher
authors.forename: X
authors.initials: X
authors.lastname: Rogiers
authors.forename: M
authors.initials: M
authors.lastname: Stangl
authors.forename: W
authors.initials: W
authors.lastname: Hohenberger
authors.forename: V
authors.initials: V
authors.lastname: Müller
authors.forename: E P
authors.initials: EP
authors.lastname: Molmenti
authors.forename: I
authors.initials: I
authors.lastname: Fouzas
authors.forename: J
authors.initials: J
authors.lastname: Erhard
authors.forename: M
authors.initials: M
authors.lastname: Malagó
authors.forename: A
authors.initials: A
authors.lastname: Paul
authors.forename: C E
authors.initials: CE
authors.lastname: Broelsch
authors.forename: H
authors.initials: H
authors.lastname: Lang
mesh_terms: D001650:Bile Duct Neoplasms / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic / Q000601:surgery*; D018281:Cholangiocarcinoma / Q000601:surgery*; D005858:Germany; D017052:Hospital Mortality; D006801:Humans; D016031:Liver Transplantation / Q000401:mortality / Q000502:physiology*; D012189:Retrospective Studies; D015996:Survival Rate; D017741:Survivors; D013997:Time Factors