Postoperative factors predicting outcomes in patients with Perihilar cholangiocarcinoma undergoing curative resection—a 10-year single-center experience.

Ahmad Al-Saffar, Hasan; Schultz, Nicolai; Larsen, Peter Nørrgaard; Fallentin, Eva; Willemoe, Gro Linno; Renteria Ramirez, Diana Elena; Knøfler, Lucas Alexander; Pommergaard, Hans-Christian

Background: Perihilar cholangiocarcinoma (pCCA) has a 5-year overall survival (OS) ranging from 10–40%, following resection. However, prognostic models for postoperative outcomes are limited by long study timespan and variations in work-up. We investigated postoperative outcomes in patients resected for pCCA in a high-volume center with standardized work-up. Method: Patients resected with confirmed pCCA, between 2013 and 2023, were included. Cox-regression investigated association between postoperative factors and OS as well as disease-free survival (DFS). Results: Totally, 65 patients were resected for pCCA. The 1-, 3- and 5-year OS rates were 86.1%, 56.5% and 32.6% respectively. The 1-, 3- and 5-year DFS rates were 67.7%, 40.0% and 26.8%, respectively. Portal vein embolization (PVE) (HR 4.52 [CI 1.66–12.27], p = 0.003), lymph node metastasis (LNM) (HR 6.37 [CI 2.06–19.67], p = 0.001) and Clavien-Dindo (CD) ≥3a (HR 2.83 [CI 1.43–5.56], p = 0.002) were associated with inferior OS. Clavien-Dindo (CD) ≥3a (HR 2.10 [CI 1.05–4.22], p = 0.03) and T-stage >2 (HR 2.36 [CI 1.01, 5.05], p = 0.04) were associated with inferior and superior DFS, respectively. Conclusion: PVE, T-stage >2, LNM and CD ≥ III were associated with worse prognosis in resected pCCA. Research is needed to improve pre-operative detection of oncological features and patients with risk of major surgical complications.

PROGRESSION-free survival; PREOPERATIVE risk factors; OVERALL survival; CANCER patients; LYMPHATIC metastasis

Scandinavian Journal of Gastroenterology, 2025, Vol 60, Issue 1, p73

0036-5521

Academic Journal

10.1080/00365521.2024.2443515