title: Surgical procedure and long-term survival of hilar cholangiocarcinoma.
abstract: OBJECTIVE
  The aim of this study was to identify the influencing factors related to outcome of patients with hilar cholangiocarcinoma.
  
  
  METHODS
  From January 1999 to January 2009, 204 cases of hilar cholangiocarcinoma undergoing surgery were analyzed retrospectively. Bismuth-Corlette classification showed type I in 18 patients, type II in 40, type IIIa in 65, type IIIb in 54, type IV in 27. Survival analysis was performed by the Kaplan-Meier method and the relationship between each of the clinicopathologic variables and survival was assessed by the log-rank test. Multivatiate results were confirmed using Cox regression.
  
  
  RESULTS
  Radical resection was accomplished in 161 of 204 patients (78.9%). Radical resection offered the best chance of long-term survival, with the 1-, 3-, and 5-year survival rate were 62.6%, 42.4%, 23.7%, respectively. Univariate analysis showed that lymph node metastasis, surgical margin, operative procedure and tumor differentiation were prognostic impacts. The difference was statistically significant (P < 0.05). Cox multivariate analysis showed that lymph node metastasis and surgical margin are two separate prognostic factors.
  
  
  CONCLUSIONS
  Racical resection is the key to improve the long-term survival rate of hilar cholangiocarcinoma and a favorable outcome after resection is mainly determined by curative resection and the absence of lymph node metastasis.
authors.affiliation: Department of Anesthesiology, Liaoning Cancer Hospital and Institute Shenyang, China.
authors.forename: Yue
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Institute of Public Health, University of California San Francisco, USA.
authors.forename: Helen
authors.initials: H
authors.lastname: Yang
authors.affiliation: The Department of General Surgery, Shen Zhou Hospital, Shen Yang Medical College Shenyang, China.
authors.forename: Chunjian
authors.initials: C
authors.lastname: Shen
authors.affiliation: The Department of General Surgery, The First Hospital of China Medical University Shenyang, China.
authors.forename: Ji
authors.initials: J
authors.lastname: Luo
keywords: Cholangiocarcinoma; prognosis; survival