BACKGROUND: Achievement of negative margins is the goal of curative intent surgery for hilar cholangiocarcinoma. This study analyzed factors affecting survival in hilar cholangiocarcinoma patients and compared short- and long-term outcomes of left- and right-sided resections. METHODS: One hundred and five patients out of 124 diagnosed with Klatskin tumors underwent major liver resection. Sixty-one patients underwent right-sided resections (right group), whereas 44 underwent left-sided resections (left group). Perioperative morbidity, perioperative mortality, and overall and disease-free survival were compared between the groups. RESULTS: Morbidity and mortality were higher in the right group (59 and 8.2%, respectively) than in the left group (38.6 and 2.3%, respectively) (p < 0.005). The most frequent cause of death was liver failure. The R0 rate was 75.4% in the right and 61.4% in the left group. The 5-year survival rate was 42.8% in the right and 35.3% in the left group (p < 0.05). Patients in the left group more frequently developed local recurrence (87 vs. 69% in the right group). CONCLUSION: Lesion side impacts outcome: right resections still cause significant morbidity related to extensive parenchymal sacrifice but are associated with better long-term survival because right hepatic pedicle resection enables better radicality compared with left resections.
BACKGROUND: Achievement of negative margins is the goal of curative intent surgery for hilar cholangiocarcinoma. This study analyzed factors affecting survival in hilar cholangiocarcinomapatients and compared short- and long-term outcomes of left- and right-sided resections. METHODS: One hundred and five patients out of 124 diagnosed with Klatskin tumors underwent major liver resection. Sixty-one patients underwent right-sided resections (right group), whereas 44 underwent left-sided resections (left group). Perioperative morbidity, perioperative mortality, and overall and disease-free survival were compared between the groups. RESULTS: Morbidity and mortality were higher in the right group (59 and 8.2%, respectively) than in the left group (38.6 and 2.3%, respectively) (p < 0.005). The most frequent cause of death was liver failure. The R0 rate was 75.4% in the right and 61.4% in the left group. The 5-year survival rate was 42.8% in the right and 35.3% in the left group (p < 0.05). Patients in the left group more frequently developed local recurrence (87 vs. 69% in the right group). CONCLUSION: Lesion side impacts outcome: right resections still cause significant morbidity related to extensive parenchymal sacrifice but are associated with better long-term survival because right hepatic pedicle resection enables better radicality compared with left resections.
Authors: Michael F Gerhards; Thomas M van Gulik; Dioniso González González; Erik A J Rauws; Dirk J Gouma Journal: World J Surg Date: 2003-02 Impact factor: 3.352
Authors: D Gomez; P B Patel; C Lacasia-Purroy; C Byrne; R P Sturgess; D Palmer; S Fenwick; G J Poston; H Z Malik Journal: Eur J Surg Oncol Date: 2013-10-23 Impact factor: 4.424
Authors: Nuh N Rahbari; O James Garden; Robert Padbury; Mark Brooke-Smith; Michael Crawford; Rene Adam; Moritz Koch; Masatoshi Makuuchi; Ronald P Dematteo; Christopher Christophi; Simon Banting; Val Usatoff; Masato Nagino; Guy Maddern; Thomas J Hugh; Jean-Nicolas Vauthey; Paul Greig; Myrddin Rees; Yukihiro Yokoyama; Sheung Tat Fan; Yuji Nimura; Joan Figueras; Lorenzo Capussotti; Markus W Büchler; Jürgen Weitz Journal: Surgery Date: 2011-01-14 Impact factor: 3.982
Authors: T M van Gulik; J J Kloek; A T Ruys; O R C Busch; G J van Tienhoven; J S Lameris; E A J Rauws; D J Gouma Journal: Eur J Surg Oncol Date: 2010-11-27 Impact factor: 4.424
Authors: Lotte C Franken; Pim B Olthof; Joris I Erdmann; Otto M van Delden; Joanne Verheij; Marc G Besselink; Olivier R Busch; Thomas M van Gulik Journal: Hepatobiliary Surg Nutr Date: 2021-04 Impact factor: 8.265