title: Experience of surgical resection for hilar cholangiocarcinomas at a Japanese single cancer institute.
abstract: OBJECTIVE
  Surgical resection is a radical treatment option for hilar bile duct carcinoma (HBDC); however, it is still difficult to cure and postoperative morbidity is high at this stage.
  
  
  METHODS
  We examined the demographics, surgical records and outcome in 38 patients with hilar cholangiocarcinoma undergoing operation.
  
  
  RESULTS
  Five patients (13%) underwent probe laparotomy because of peritoneal dissemination or liver metastasis. Of 33 patients, extended hemi-hepatectomy was performed in 32 patients. Postoperative complications were observed in 46% including hepatic failure in 3 and hospital death was observed in 4 patients. Advanced tumor stage more than stage III was observed in 23 patients. Curability of operation was A in 5 patients, B in 17 and C in 11 and postoperative adjuvant chemotherapy was administered in 24% including photodynamic therapy in 3. Tumor recurrence was observed in 41% of HBDC patients. The 3- and 5-year tumor-free survival was 38% and 10%, respectively and 3- and 5-year overall survival was 48% and 32%, respectively. By comparison with tumor stage or final curability, survival rates were not significantly different between groups.
  
  
  CONCLUSIONS
  Surgical resection is still the only curative treatment option to improve patient survival even in advanced stage HBDC.
authors.affiliation: Department of Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. a-nanasm@nagasaki-u.ac.jp
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nanashima
authors.forename: Syuuichi
authors.initials: S
authors.lastname: Tobinaga
authors.forename: Takafumi
authors.initials: T
authors.lastname: Abo
authors.forename: Ryusuke
authors.initials: R
authors.lastname: Machino
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Takeshita
authors.forename: Takashi
authors.initials: T
authors.lastname: Nonaka
authors.forename: Shigekazu
authors.initials: S
authors.lastname: Hidaka
authors.forename: Kenji
authors.initials: K
authors.lastname: Tanaka
authors.forename: Masaki
authors.initials: M
authors.lastname: Kunizaki
authors.forename: Terumitsu
authors.initials: T
authors.lastname: Sawai
authors.forename: Toru
authors.initials: T
authors.lastname: Yasutake
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nagayasu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic / Q000473:pathology / Q000601:surgery*; D001662:Biliary Tract Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D017024:Chemotherapy, Adjuvant; D018281:Cholangiocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000401:mortality; D017052:Hospital Mortality; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D010778:Photochemotherapy; D016019:Survival Analysis; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome