title: Liver transplantation for hilar cholangiocarcinoma.
abstract: The most appropriate treatment for Klatskin tumor (KT) with a curative intention is multimodal therapy based on achieving resection with tumour-free margins (R0 resections) combined with other types of neoadjuvant or adjuvant treatment (the most important factor affecting KT survival is the possibility of R0 resections, achieving 5-year survival rate of 40%-50%). Thirty to forty percent of patients with KT are inoperable and present a 5-year survival rate of 0%. In irresectable non-disseminated KT patients, using liver transplantation without neoadjuvant treatment, the 5-year survival rate increase to 38%, reaching 50% survival in early stage. In selected cases, with liver transplantation and neoadjuvant treatment (chemotherapy and radiotherapy), the actuarial survival rate is 65% at 5 years and 59% at 10 years. In conclusion, correct staging, neoadjuvant treatment, living donor and priority on the liver transplant waiting list may lead to improved results.
authors.affiliation: Ricardo Robles, Francisco Sánchez-Bueno, Pablo Ramírez, Roberto Brusadin, Pascual Parrilla, Department of Surgery and Liver and Pancreas transplantation, Virgen de la Arrixaca Clinic and University Hospital, E-30120 Murcia, Spain.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Robles
authors.affiliation: Ricardo Robles, Francisco Sánchez-Bueno, Pablo Ramírez, Roberto Brusadin, Pascual Parrilla, Department of Surgery and Liver and Pancreas transplantation, Virgen de la Arrixaca Clinic and University Hospital, E-30120 Murcia, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Sánchez-Bueno
authors.affiliation: Ricardo Robles, Francisco Sánchez-Bueno, Pablo Ramírez, Roberto Brusadin, Pascual Parrilla, Department of Surgery and Liver and Pancreas transplantation, Virgen de la Arrixaca Clinic and University Hospital, E-30120 Murcia, Spain.
authors.forename: Pablo
authors.initials: P
authors.lastname: Ramírez
authors.affiliation: Ricardo Robles, Francisco Sánchez-Bueno, Pablo Ramírez, Roberto Brusadin, Pascual Parrilla, Department of Surgery and Liver and Pancreas transplantation, Virgen de la Arrixaca Clinic and University Hospital, E-30120 Murcia, Spain.
authors.forename: Roberto
authors.initials: R
authors.lastname: Brusadin
authors.affiliation: Ricardo Robles, Francisco Sánchez-Bueno, Pablo Ramírez, Roberto Brusadin, Pascual Parrilla, Department of Surgery and Liver and Pancreas transplantation, Virgen de la Arrixaca Clinic and University Hospital, E-30120 Murcia, Spain.
authors.forename: Pascual
authors.initials: P
authors.lastname: Parrilla
mesh_terms: D001650:Bile Duct Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic / Q000473:pathology / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D018281:Cholangiocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D006500:Hepatic Duct, Common / Q000473:pathology / Q000601:surgery*; D006801:Humans; D018285:Klatskin Tumor / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects / Q000401:mortality; D019520:Living Donors; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D018714:Radiotherapy, Adjuvant; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014850:Waiting Lists
keywords: Cholangiocarcinoma; Klatskin tumour; Liver surgery; Liver transplantation; Primary sclerosing cholangitis