title: Correlation of staging systems to survival in patients with resected hilar cholangiocarcinoma.
abstract: BACKGROUND
  We aimed to identify staging parameters associated with survival in patients with hilar cholangiocarcinoma.
  
  
  METHODS
  Clinicopathologic characteristics were obtained retrospectively for all resected patients with Bismuth-Corlette III cholangiocarcinoma between 1993 and 2011. Patients were stratified by the American Joint Commission on Cancer (AJCC) (7th edition) and Memorial Sloan-Kettering Cancer Center (MSKCC) staging systems. Survival analyses tested the effects of clinicopathologic factors and staging covariates on recurrence-free and overall survival.
  
  
  RESULTS
  Eighty patients (mean age 63 ± 11 years, 63% male) underwent anatomic hepatectomy with bile duct resection/reconstruction for Bismuth-Corlette IIIa (53%) and IIIb (47%) cholangiocarcinoma. The median follow-up was 26 months (interquartile range = 12 to 50 months), and the median time to recurrence was 15 months (interquartile range = 6 to 38 months). Neither AJCC nor MSKCC staging systems were associated with recurrence-free survival (all P ≥ .059). MSKCC T-stage but not the AJCC staging system was associated with overall survival (P ≤ .026).
  
  
  CONCLUSIONS
  MSKCC T-stage classification but not AJCC staging is independently associated with overall survival for patients after resection of hilar cholangiocarcinoma.
authors.affiliation: Division of Gastroenterologic and General Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
authors.forename: Victor M
authors.initials: VM
authors.lastname: Zaydfudim
authors.forename: Clancy J
authors.initials: CJ
authors.lastname: Clark
authors.forename: Michael L
authors.initials: ML
authors.lastname: Kendrick
authors.forename: Florencia G
authors.initials: FG
authors.lastname: Que
authors.forename: Kaye M
authors.initials: KM
authors.lastname: Reid-Lombardo
authors.forename: John H
authors.initials: JH
authors.lastname: Donohue
authors.forename: Michael B
authors.initials: MB
authors.lastname: Farnell
authors.forename: David M
authors.initials: DM
authors.lastname: Nagorney
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D001650:Bile Duct Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D001653:Bile Ducts, Intrahepatic / Q000473:pathology / Q000601:surgery; D018281:Cholangiocarcinoma / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging / Q000379:methods*; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies
keywords: American Joint Commission on Cancer stage; Bismuth-Corlette; Hilar cholangiocarcinoma; Memorial Sloan-Kettering Cancer Center stage; Survival