Outcomes after vascular resection during curative-intent resection for hilar cholangiocarcinoma: a multi-institution study from the US extrahepatic biliary malignancy consortium.

Schimizzi, GV ; Jin, LX ; et al.

In: HPB : the official journal of the International Hepato Pancreato Biliary Association, Jg. 20 (2018-04-01), Heft 4, S. 332-339

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Background: Surgical resection is the cornerstone of curative-intent therapy for patients with hilar cholangiocarcinoma (HC). The role of vascular resection (VR) in the treatment of HC in western centres is not well defined.

Methods: Utilizing data from the U.S. Extrahepatic Biliary Malignancy Consortium, patients were grouped into those who underwent resection for HC based on VR status: no VR, portal vein resection (PVR), or hepatic artery resection (HAR). Perioperative and long-term survival outcomes were analyzed.

Results: Between 1998 and 2015, 201 patients underwent resection for HC, of which 31 (15%) underwent VR: 19 patients (9%) underwent PVR alone and 12 patients (6%) underwent HAR either with (n = 2) or without PVR (n = 10). Patients selected for VR tended to be younger with higher stage disease. Rates of postoperative complications and 30-day mortality were similar when stratified by vascular resection status. On multivariate analysis, receipt of PVR or HAR did not significantly affect OS or RFS.

Conclusion: In a modern, multi-institutional cohort of patients undergoing curative-intent resection for HC, VR appears to be a safe procedure in a highly selected subset, although long-term survival outcomes appear equivalent. VR should be considered only in select patients based on tumor and patient characteristics.

Titel:	Outcomes after vascular resection during curative-intent resection for hilar cholangiocarcinoma: a multi-institution study from the US extrahepatic biliary malignancy consortium.
Autor/in / Beteiligte Person:	Schimizzi, GV ; Jin, LX ; Davidson JT 4th ; Krasnick, BA ; Ethun, CG ; Pawlik, TM ; Poultsides, G ; Tran, T ; Idrees, K ; Isom, CA ; Weber, SM ; Salem, A ; Hawkins, WG ; Strasberg, SM ; Doyle, MB ; Chapman, WC ; Martin, RCG ; Scoggins, C ; Shen, P ; Mogal, HD ; Schmidt, C ; Beal, E ; Hatzaras, I ; Shenoy, R ; Maithel, SK ; Fields, RC
Link:	Full Text Finder (Volltext)
Zeitschrift:	HPB : the official journal of the International Hepato Pancreato Biliary Association, Jg. 20 (2018-04-01), Heft 4, S. 332-339
Veröffentlichung:	2016- : Oxford, UK : Elsevier ; <i>Original Publication</i>: 1999-2001: Oxford, England : ISIS Medical Media, 2018
Medientyp:	academicJournal
ISSN:	1477-2574 (electronic)
DOI:	10.1016/j.hpb.2017.10.003
Schlagwort:	Aged Bile Duct Neoplasms diagnostic imaging Bile Duct Neoplasms mortality Bile Duct Neoplasms pathology Databases, Factual Female Hepatic Artery diagnostic imaging Hepatic Artery pathology Humans Klatskin Tumor diagnostic imaging Klatskin Tumor mortality Klatskin Tumor pathology Male Middle Aged Neoplasm Grading Neoplasm Staging Portal Vein diagnostic imaging Portal Vein pathology Postoperative Complications etiology Retrospective Studies Risk Factors Time Factors Treatment Outcome United States Bile Duct Neoplasms surgery Cholecystectomy adverse effects Cholecystectomy mortality Hepatectomy adverse effects Hepatectomy mortality Hepatic Artery surgery Klatskin Tumor surgery Pancreaticoduodenectomy adverse effects Pancreaticoduodenectomy mortality Portal Vein surgery Vascular Surgical Procedures adverse effects Vascular Surgical Procedures mortality
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article; Multicenter Study Language: English [HPB (Oxford)] 2018 Apr; Vol. 20 (4), pp. 332-339. <i>Date of Electronic Publication: </i>2017 Nov 21. MeSH Terms: Cholecystectomy* / adverse effects ; Cholecystectomy* / mortality ; Hepatectomy* / adverse effects ; Hepatectomy* / mortality ; Pancreaticoduodenectomy* / adverse effects ; Pancreaticoduodenectomy* / mortality ; Vascular Surgical Procedures* / adverse effects ; Vascular Surgical Procedures* / mortality ; Bile Duct Neoplasms / surgery ; Hepatic Artery / surgery ; Klatskin Tumor / surgery ; Portal Vein / surgery ; Aged ; Bile Duct Neoplasms / diagnostic imaging ; Bile Duct Neoplasms / mortality ; Bile Duct Neoplasms / pathology ; Databases, Factual ; Female ; Hepatic Artery / diagnostic imaging ; Hepatic Artery / pathology ; Humans ; Klatskin Tumor / diagnostic imaging ; Klatskin Tumor / mortality ; Klatskin Tumor / pathology ; Male ; Middle Aged ; Neoplasm Grading ; Neoplasm Staging ; Portal Vein / diagnostic imaging ; Portal Vein / pathology ; Postoperative Complications / etiology ; Retrospective Studies ; Risk Factors ; Time Factors ; Treatment Outcome ; United States References: J Hepatobiliary Pancreat Surg. 2002;9(2):237-41. (PMID: 12140613) ; Arch Surg. 2012 Jan;147(1):26-34. (PMID: 22250108) ; Oncologist. 2004;9(1):43-57. (PMID: 14755014) ; J Hepatobiliary Pancreat Sci. 2010 Jul;17(4):455-62. (PMID: 19820891) ; Ann Surg. 2003 Nov;238(5):720-7. (PMID: 14578735) ; Ann Surg Oncol. 2016 Aug;23(Suppl 4):475-484. (PMID: 27387681) ; Surgery. 2007 May;141(5):581-8. (PMID: 17462457) ; J Am Coll Surg. 2013 Feb;216(2):192-200. (PMID: 23266423) ; J Hepatobiliary Pancreat Sci. 2010 Jul;17(4):449-54. (PMID: 19806294) ; Hepatobiliary Pancreat Dis Int. 2015 Dec;14(6):626-32. (PMID: 26663011) ; Ann Surg. 2009 Aug;250(2):187-96. (PMID: 19638912) ; Semin Liver Dis. 2004 May;24(2):115-25. (PMID: 15192785) ; Med Oncol. 2015 Nov;32(11):245. (PMID: 26427701) ; Curr Opin Gastroenterol. 2007 May;23(3):317-23. (PMID: 17414849) ; HPB (Oxford). 2014 Jan;16(1):56-61. (PMID: 23461754) ; J Am Coll Surg. 2011 Apr;212(4):604-13; discussion 613-6. (PMID: 21463797) ; J Gastrointest Surg. 2014 Nov;18(11):1917-28. (PMID: 25199947) ; Am J Clin Oncol. 2006 Apr;29(2):127-31. (PMID: 16601429) ; Cancer. 2012 Oct 1;118(19):4737-47. (PMID: 22415526) ; Gut. 2012 Dec;61(12):1657-69. (PMID: 22895392) ; J Hepatobiliary Pancreat Sci. 2010 Jul;17(4):490-6. (PMID: 19806295) ; Ann Surg Oncol. 2010 Jun;17(6):1471-4. (PMID: 20180029) Grant Information: K12 CA090625 United States CA NCI NIH HHS; P30 CA016058 United States CA NCI NIH HHS; T32 CA009621 United States CA NCI NIH HHS Entry Date(s): Date Created: 20171125 Date Completed: 20190528 Latest Revision: 20231112 Update Code: 20231215 PubMed Central ID: PMC5970648

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