title: Tumour size over 3 cm predicts poor short-term outcomes after major liver resection for hilar cholangiocarcinoma. By the HC-AFC-2009 group.
abstract: BACKGROUND
  As mortality and morbidity after a curative resection remains high, it is essential to identify pre-operative factors associated with an early death after a major resection.
  
  
  METHODS
  Between 1998 and 2008, we selected a population of 331 patients having undergone a major hepatectomy including segment I with a lymphadenectomy and a common bile duct resection for a proven hilar cholangiocarcinoma in 21 tertiary centres. The study's objective was to identify pre-operative predictors of early death (<12 months) after a resection.
  
  
  RESULTS
  The study cohort consisted of 221 men and 110 women, with a median age of 61 years (range: 24-85). The post-operative mortality and morbidity rates were 8.2% and 61%, respectively. The 1-, 3- and 5-year overall survival rates were 85%, 64% and 53%, respectively. The median tumour size was 23 mm on pathology, ranging from 8 to 40. A tumour size >30 mm [odds ratio (OR) 2.471 (95% confidence interval (CI) 1.136-7.339), P = 0.001] and major post-operative complication [OR 3.369 (95% CI 1.038-10.938), P = 0.004] were independently associated with death <12 months in a multivariate analysis.
  
  
  CONCLUSIONS
  The present analysis of a series of 331 patients with hilar cholangiocarcinoma showed that tumour size >30 mm was independently associated with death <12 months.
authors.affiliation: Department of Digestive and Metabolic Surgery, Amiens University Medical Center, Amiens, France.
authors.forename: Jean Marc
authors.initials: JM
authors.lastname: Regimbeau
authors.forename: David
authors.initials: D
authors.lastname: Fuks
authors.forename: Patrick
authors.initials: P
authors.lastname: Pessaux
authors.forename: Philippe
authors.initials: P
authors.lastname: Bachellier
authors.forename: Denis
authors.initials: D
authors.lastname: Chatelain
authors.forename: Momar
authors.initials: M
authors.lastname: Diouf
authors.forename: Artigas
authors.initials: A
authors.lastname: Raventos
authors.forename: Georges
authors.initials: G
authors.lastname: Mantion
authors.forename: Jean-Francois
authors.initials: JF
authors.lastname: Gigot
authors.forename: Laurence
authors.initials: L
authors.lastname: Chiche
authors.forename: Gerard
authors.initials: G
authors.lastname: Pascal
authors.forename: Daniel
authors.initials: D
authors.lastname: Azoulay
authors.forename: Alexis
authors.initials: A
authors.lastname: Laurent
authors.forename: Christian
authors.initials: C
authors.lastname: Letoublon
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Boleslawski
authors.forename: Michel
authors.initials: M
authors.lastname: Rivoire
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Mabrut
authors.forename: Mustapha
authors.initials: M
authors.lastname: Adham
authors.forename: Yves-Patrice
authors.initials: YP
authors.lastname: Le Treut
authors.forename: Jean-Robert
authors.initials: JR
authors.lastname: Delpero
authors.forename: Francis
authors.initials: F
authors.lastname: Navarro
authors.forename: Ahmet
authors.initials: A
authors.lastname: Ayav
authors.forename: Karim
authors.initials: K
authors.lastname: Boudjema
authors.forename: Gennaro
authors.initials: G
authors.lastname: Nuzzo
authors.forename: Michel
authors.initials: M
authors.lastname: Scotte
authors.forename: Olivier
authors.initials: O
authors.lastname: Farges
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*; D016009:Chi-Square Distribution; D018281:Cholangiocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D005602:France; D006498:Hepatectomy / Q000009:adverse effects* / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D047368:Tumor Burden; D055815:Young Adult