title: Surgical and combined treatment of patients with cholangiocellular carcinoma.
abstract: BACKGROUND
  Liver resection is the essential method of cholangiocellular carcinoma treatment. However due to low resectability and high incidence of recurrences search for additional curative methods is necessary.
  
  
  OBJECTIVE
  To improve the results of surgical treatment of patients with cholangiocellular carcinoma especially with complications and poor prognosis.
  
  
  METHODS
  A total of 95 surgical procedures for intrahepatic cholangiocarcinoma have been performed in the department of liver andpancreatic tumors at N.N. Blokhin Russian Cancer Research Center since 1998 to 2014. 11 patients had obstructive jaundice as the first symptom of the disease. Extended liver resections were done in most cases (84.2%). Preoperative treatment was performed in 3 patients. Adjuvant chemotherapy after R0-resection was applied in 15 patients.
  
  
  RESULTS
  The postoperative mortality rate was 4.2%. Postoperative complications were observed in 51 (53.7%) patients. Complication grade III after adjuvant chemotherapy was observed in one (6.7%) patient. Median survival after liver resection was 25 months, 5-year survival rate - 25.3%. In stage I-II five-year survival reached 66.7%. In patients with obstructive jaundice 5-year survival rate was 26.7%, median survival - 37 months. There was no improvement of survival in case of adjuvant therapy.
  
  
  CONCLUSIONS
  Liver resection remains essential treatment of cholangiocellular carcinoma including patients with obstructive jaundice. Additional curative methods are necessary to increase resectability and decrease the risk of recurrence.
authors.affiliation: Department of liver and pancreatic tumors, Moscow.
authors.forename: Yu I
authors.initials: YI
authors.lastname: Patyutko
authors.affiliation: Department of liver and pancreatic tumors, Moscow.
authors.forename: A N
authors.initials: AN
authors.lastname: Polyakov
authors.affiliation: Department of liver and pancreatic tumors, Moscow.
authors.forename: A G
authors.initials: AG
authors.lastname: Kotel'nikov
authors.affiliation: Department of liver and pancreatic tumors, Moscow.
authors.forename: I V
authors.initials: IV
authors.lastname: Sagaydak
authors.affiliation: Department of liver and pancreatic tumors, Moscow.
authors.forename: A D
authors.initials: AD
authors.lastname: Gahramanov
authors.affiliation: Department of liver and pancreatic tumors, Moscow.
authors.forename: O V
authors.initials: OV
authors.lastname: Chistyakova
authors.affiliation: Department of liver and pancreatic tumors, Moscow.
authors.forename: E A
authors.initials: EA
authors.lastname: Moroz
mesh_terms: D000328:Adult; D000368:Aged; D001650:Bile Duct Neoplasms / Q000175:diagnosis / Q000628:therapy*; D018281:Cholangiocarcinoma / Q000175:diagnosis / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D016896:Treatment Outcome