AIM: To investigate the clinical value of T-staging system in the preoperative assessment of hilar cholangiocarcinoma. METHODS: From March 1993 to January 2006, 85 patients who had cholangiocarcinoma diagnosed by operative tissue-biopsy were placed into one of three stages based on the new T-staging system, and it was evaluated the resectability and survival correlated with T-staging. RESULTS: The likelihood of resection and achieving tumor-free margin decreased progressively with increasing T stage (P < 0.05). The cumulative 1-year survival rates of T1, T2 and T3 patients were 71.8%, 50.8% and 12.9% respectively, and the cumulative 3-year survival rate was 34.4%, 18.2% and 0% respectively; the survival of different stage patients differed markedly (P < 0.001). Median survival in the hepatic resection group was greater than in the group that did not undergo hepatic resection (28 mo vs 18 mo; P < 0.05). The overall accuracy for combined MRCP and color Doppler Ultrasonagraphy detecting disease was higher than that of combined using CT and color Doppler Ultrasonagraphy (91.4% vs 68%; P < 0.05 ). And it was also higher in detecting port vein involvement (90% vs 54.5%; P < 0.05). CONCLUSION: The proposed staging system for hilar cholangiocarcinoma can accurately predict resectability, the likelihood of metastatic disease, and survival. A concomitant partial hepatectomy would help to attain curative resection and the possibility of long-term survival. MRCP/MRA coupled with color Doppler Ultrasonagraphy was necessary for preoperative evaluation of hilar cholangiocarcinoma.
AIM: To investigate the clinical value of T-staging system in the preoperative assessment of hilar cholangiocarcinoma. METHODS: From March 1993 to January 2006, 85 patients who had cholangiocarcinoma diagnosed by operative tissue-biopsy were placed into one of three stages based on the new T-staging system, and it was evaluated the resectability and survival correlated with T-staging. RESULTS: The likelihood of resection and achieving tumor-free margin decreased progressively with increasing T stage (P < 0.05). The cumulative 1-year survival rates of T1, T2 and T3 patients were 71.8%, 50.8% and 12.9% respectively, and the cumulative 3-year survival rate was 34.4%, 18.2% and 0% respectively; the survival of different stage patients differed markedly (P < 0.001). Median survival in the hepatic resection group was greater than in the group that did not undergo hepatic resection (28 mo vs 18 mo; P < 0.05). The overall accuracy for combined MRCP and color Doppler Ultrasonagraphy detecting disease was higher than that of combined using CT and color Doppler Ultrasonagraphy (91.4% vs 68%; P < 0.05 ). And it was also higher in detecting port vein involvement (90% vs 54.5%; P < 0.05). CONCLUSION: The proposed staging system for hilar cholangiocarcinoma can accurately predict resectability, the likelihood of metastatic disease, and survival. A concomitant partial hepatectomy would help to attain curative resection and the possibility of long-term survival. MRCP/MRA coupled with color Doppler Ultrasonagraphy was necessary for preoperative evaluation of hilar cholangiocarcinoma.
Authors: M Miyazaki; H Ito; K Nakagawa; S Ambiru; H Shimizu; Y Shimizu; A Okuno; S Nozawa; Y Nukui; H Yoshitomi; N Nakajima Journal: Am J Surg Date: 1998-03 Impact factor: 2.565
Authors: Emmanuel E Zervos; Dana Osborne; Steven B Goldin; Desiree V Villadolid; Donald P Thometz; Alan Durkin; Larry C Carey; Alexander S Rosemurgy Journal: Am J Surg Date: 2005-11 Impact factor: 2.565
Authors: A Nakeeb; H A Pitt; T A Sohn; J Coleman; R A Abrams; S Piantadosi; R H Hruban; K D Lillemoe; C J Yeo; J L Cameron Journal: Ann Surg Date: 1996-10 Impact factor: 12.969
Authors: Andreas Weber; Sonja Landrock; Jochen Schneider; Manfred Stangl; Bruno Neu; Peter Born; Meinhard Classen; Thomas Rösch; Roland-M Schmid; Christian Prinz Journal: World J Gastroenterol Date: 2007-03-07 Impact factor: 5.742