Our experiences in surgical treatment for hilar cholangiocarcinoma.

Background/aims: Although resection for hilar cholangiocarcinoma usually requires difficult surgical manipulations, it is only one therapeutic modality for a permanent cure or a desirable prognosis. We verified our own experiences after surgical treatment for hilar cholangiocarcinoma.

Methodology: This study included 24 patients with hilar cholangiocarcinoma from 1981 to 2002. The current study mainly evaluated postoperative complications and overall prognosis after resection.

Results: Twenty-one patients received tumor resection. Hepatic resection including extended hepatectomy was required in 19 patients (90.5%). Postoperative morbidity was observed in 16 (71.2%), and motality in 2 (9.5%). The overall 5-year survival rate was 33.7%, and median survival was 35.7 months. Tumor extent in the TNM stage (p = 0.011) and the existence of lymph node metastases (p = 0.038) were identified as significant prognostic factors in overall survival after operation by univariate analysis. Postoperative adjuvant radio-chemotherapy after resection improved their prognosis (p = 0.010).

Conclusions: Our results suggest that aggressive resection and appropriate adjuvant therapies for hilar cholangiocarcinoma might make a better prognosis possible, especially in patients without lymph node metastases excluding advanced tumor.