Hannes Jansson1, Pim B Olthof2, Annika Bergquist3, Marjolein A P Ligthart4, Silvio Nadalin5, Roberto I Troisi6, Bas Groot Koerkamp7, Ruslan Alikhanov8, Hauke Lang9, Alfredo Guglielmi10, Matteo Cescon11, William R Jarnagin12, Luca Aldrighetti13, Thomas M van Gulik2, Ernesto Sparrelid14. 1. Division of Surgery, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden. Electronic address: hannes.jansson@ki.se. 2. Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands. 3. Unit of Gastroenterology and Rheumatology, Department of Medicine Huddinge, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden. 4. Department of Surgery, Maastricht University Medical Center, Maastricht, the Netherlands. 5. Department of General and Transplant Surgery, University Hospital Tübingen, Tübingen, Germany. 6. Department of Human Structure and Repair, Faculty of Medicine, Ghent University, Ghent, Belgium; Department of Clinical Medicine and Surgery, Division of HBP, Minimally Invasive and Robotic Surgery, Federico II University Naples, Naples, Italy. 7. Department of Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands. 8. Department of Hepato-Pancreato-Biliary Surgery, Moscow Clinical Scientific Center, Moscow, Russia. 9. Department of General, Visceral and Transplantation Surgery, University Hospital of Mainz, Mainz, Germany. 10. Department of Surgery, Unit of Hepato-Pancreato-Biliary Surgery, University of Verona Medical School, Verona, Italy. 11. General Surgery and Transplantation Unit, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy. 12. Division of Hepatopancreatobiliary Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA. 13. Hepato-biliary Surgery Division, Ospedale San Raffaele-IRCCS, Milan, Italy. 14. Division of Surgery, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
Abstract
BACKGROUND: Resection for perihilar cholangiocarcinoma (pCCA) in primary sclerosing cholangitis (PSC) has been reported to lead to worse outcomes than resection for non-PSC pCCA. The aim of this study was to compare prognostic factors and outcomes after resection in patients with PSC-associated pCCA and non-PSC pCCA. METHODS: The international retrospective cohort comprised patients resected for pCCA from 21 centres (2000-2020). Patients operated with hepatobiliary resection, with pCCA verified by histology and with data on PSC status, were included. The primary outcome was overall survival. Secondary outcomes were disease-free survival and postoperative complications. RESULTS: Of 1128 pCCA patients, 34 (3.0%) had underlying PSC. Median overall survival after resection was 33 months for PSC patients and 29 months for non-PSC patients (p = .630). Complications (Clavien-Dindo grade ≥ 3) were more frequent in PSC pCCA (71% versus 44%, p = .003). The rate of posthepatectomy liver failure (21% versus 17%, p = .530) and 90-day mortality (12% versus 13%, p = 1.000) was similar for PSC and non-PSC patients. CONCLUSION: Median overall survival after resection for pCCA was similar in patients with underlying PSC and non-PSC patients. Complications were more frequent after resection for PSC-associated pCCA, with no difference in postoperative mortality.
BACKGROUND: Resection for perihilar cholangiocarcinoma (pCCA) in primary sclerosing cholangitis (PSC) has been reported to lead to worse outcomes than resection for non-PSC pCCA. The aim of this study was to compare prognostic factors and outcomes after resection in patients with PSC-associated pCCA and non-PSC pCCA. METHODS: The international retrospective cohort comprised patients resected for pCCA from 21 centres (2000-2020). Patients operated with hepatobiliary resection, with pCCA verified by histology and with data on PSC status, were included. The primary outcome was overall survival. Secondary outcomes were disease-free survival and postoperative complications. RESULTS: Of 1128 pCCA patients, 34 (3.0%) had underlying PSC. Median overall survival after resection was 33 months for PSC patients and 29 months for non-PSC patients (p = .630). Complications (Clavien-Dindo grade ≥ 3) were more frequent in PSC pCCA (71% versus 44%, p = .003). The rate of posthepatectomy liver failure (21% versus 17%, p = .530) and 90-day mortality (12% versus 13%, p = 1.000) was similar for PSC and non-PSC patients. CONCLUSION: Median overall survival after resection for pCCA was similar in patients with underlying PSC and non-PSC patients. Complications were more frequent after resection for PSC-associated pCCA, with no difference in postoperative mortality.
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Authors: Pim B Olthof; Luca Aldrighetti; Ruslan Alikhanov; Matteo Cescon; Bas Groot Koerkamp; William R Jarnagin; Silvio Nadalin; Johann Pratschke; Moritz Schmelze; Ernesto Sparrelid; Hauke Lang; Alfredo Guglielmi; Thomas M van Gulik Journal: Ann Surg Oncol Date: 2020-02-26 Impact factor: 5.344