Skip to main content
Journal cover image

Recurrence Rate and Pattern of Perihilar Cholangiocarcinoma after Curative Intent Resection.

Publication ,  Conference
Groot Koerkamp, B; Wiggers, JK; Allen, PJ; Besselink, MG; Blumgart, LH; Busch, ORC; Coelen, RJ; D'Angelica, MI; DeMatteo, RP; Gouma, DJ ...
Published in: J Am Coll Surg
December 2015

BACKGROUND: The aim of this study was to investigate the rate and pattern of recurrence after curative intent resection of perihilar cholangiocarcinoma (PHC). STUDY DESIGN: Patients were included from 2 prospectively maintained databases. Recurrences were categorized by site. Time to recurrence and recurrence-free survival (RFS) were estimated using the Kaplan-Meier method. Cox proportional hazards modeling was used to identify independent poor prognostic factors. RESULTS: Between 1991 and 2012, 306 consecutive patients met inclusion criteria. Median overall survival was 40 months. A recurrence was diagnosed in 177 patients (58%). An initial local recurrence was found in 26% of patients: liver hilum (11%), hepaticojejunostomy (8%), liver resection margin (8%), or distal bile duct remnant (2%). An initial distant recurrence was observed in 40% of patients: retroperitoneal lymph nodes (14%), intrahepatic away from the resection margin (13%), peritoneum (12%), and lungs (8%). Only 18% of patients had an isolated initial local recurrence. The estimated overall recurrence rate was 76% at 8 years. After a recurrence-free period of 5 years, 28% of patients developed a recurrence in the next 3 years. Median RFS was 26 months. Independent prognostic factors for RFS were resection margin, lymph node status, and tumor differentiation. Only node-positive PHC precluded RFS beyond 7 years. CONCLUSIONS: Perihilar cholangiocarcinoma will recur in most patients (76%) after resection, emphasizing the need for better adjuvant strategies. The high recurrence rate of up to 8 years justifies prolonged surveillance. Only patients with an isolated initial local recurrence (18%) may have benefited from a more extensive resection or liver transplantation. Node-positive PHC appears incurable.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

J Am Coll Surg

DOI

EISSN

1879-1190

Publication Date

December 2015

Volume

221

Issue

6

Start / End Page

1041 / 1049

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Surgery
  • Risk Factors
  • Neoplasm Staging
  • Neoplasm Recurrence, Local
  • Middle Aged
  • Male
  • Klatskin Tumor
  • Jejunostomy
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Groot Koerkamp, B., Wiggers, J. K., Allen, P. J., Besselink, M. G., Blumgart, L. H., Busch, O. R. C., … van Gulik, T. M. (2015). Recurrence Rate and Pattern of Perihilar Cholangiocarcinoma after Curative Intent Resection. In J Am Coll Surg (Vol. 221, pp. 1041–1049). United States. https://doi.org/10.1016/j.jamcollsurg.2015.09.005
Groot Koerkamp, Bas, Jimme K. Wiggers, Peter J. Allen, Marc G. Besselink, Leslie H. Blumgart, Olivier R. C. Busch, Robert J. Coelen, et al. “Recurrence Rate and Pattern of Perihilar Cholangiocarcinoma after Curative Intent Resection.” In J Am Coll Surg, 221:1041–49, 2015. https://doi.org/10.1016/j.jamcollsurg.2015.09.005.
Groot Koerkamp B, Wiggers JK, Allen PJ, Besselink MG, Blumgart LH, Busch ORC, et al. Recurrence Rate and Pattern of Perihilar Cholangiocarcinoma after Curative Intent Resection. In: J Am Coll Surg. 2015. p. 1041–9.
Groot Koerkamp, Bas, et al. “Recurrence Rate and Pattern of Perihilar Cholangiocarcinoma after Curative Intent Resection.J Am Coll Surg, vol. 221, no. 6, 2015, pp. 1041–49. Pubmed, doi:10.1016/j.jamcollsurg.2015.09.005.
Groot Koerkamp B, Wiggers JK, Allen PJ, Besselink MG, Blumgart LH, Busch ORC, Coelen RJ, D’Angelica MI, DeMatteo RP, Gouma DJ, Kingham TP, Jarnagin WR, van Gulik TM. Recurrence Rate and Pattern of Perihilar Cholangiocarcinoma after Curative Intent Resection. J Am Coll Surg. 2015. p. 1041–1049.
Journal cover image

Published In

J Am Coll Surg

DOI

EISSN

1879-1190

Publication Date

December 2015

Volume

221

Issue

6

Start / End Page

1041 / 1049

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Surgery
  • Risk Factors
  • Neoplasm Staging
  • Neoplasm Recurrence, Local
  • Middle Aged
  • Male
  • Klatskin Tumor
  • Jejunostomy
  • Humans