Experience of surgical resection for hilar cholangiocarcinomas at a Japanese single cancer institute.

BACKGROUND/AIMS: Surgical resection is a radical treatment option for hilar bile duct carcinoma (HBDC); however, it is still difficult to cure and postoperative morbidity is high at this stage.

METHODOLOGY: We examined the demographics, surgical records and outcome in 38 patients with hilar cholangiocarcinoma undergoing operation.

RESULTS

Five patients (13%) underwent probe laparotomy because of peritoneal dissemination or liver metastasis. Of 33 patients, extended hemi-hepatectomy was performed in 32 patients. Postoperative complications were observed in 46% including hepatic failure in 3 and hospital death was observed in 4 patients. Advanced tumor stage more than stage III was observed in 23 patients. Curability of operation was A in 5 patients, B in 17 and C in 11 and postoperative adjuvant chemotherapy was administered in 24% including photodynamic therapy in 3. Tumor recurrence was observed in 41% of HBDC patients. The 3- and 5-year tumor-free survival was 38% and 10%, respectively and 3- and 5-year overall survival was 48% and 32%, respectively. By comparison with tumor stage or final curability, survival rates were not significantly different between groups.

CONCLUSIONS

Surgical resection is still the only curative treatment option to improve patient survival even in advanced stage HBDC.