[Malignant tumors of the hepatic bifurcation--results of surgical therapy and prognostic factors].

Between 1 January 1986 and 31 December 1994, 45 patients with carcinoma of the hepatic bifurcation underwent operations in the department of surgery. According to Bismuth's classification (1992), there were 7 type I, 4 type II, 22 type III and 12 type IV tumors. 31 of the 45 patients (68.9%) underwent surgical resections with curative intentions: resection of the hepatic bifurcation (n = 9, 29%), resection of the hepatic bifurcation with hilar liver resection (n = 7, 22.6%), resection of the hepatic bifurcation with left hemihepatectomy (n = 10, 32.3%), orthotopic liver transplantation (n = 5, 16.1%). The remaining 14 patients underwent palliative (n = 6) or diagnostic (n = 8) operations. Two of the 45 patients (4.2%) died in hospital. Histological examination demonstrated R0 resection in 17 of 31 (54.8%) of the patients, while in the remaining 14 cases, only a R1/RX resection had been achieved. One-, 2- and 5-year survival rates were 75.4%, 53.9% and 24.5% (median survival: 729 days) in the 31 resected patients, and 30.8%, 10.3% and 0% (median survival: 153 days) in the palliative treatment group. A statistically significant influence on survival could be demonstrated for nodal status (N0/N1) and residual tumor status (R0/R1, R2).