1. Strict Selection Alone of Patients Undergoing Liver Transplantation for Hilar Cholangiocarcinoma Is Associated with Improved Survival
- Author
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Mantel, Hendrik T. J., Westerkamp, Andrie C., Adam, René, Bennet, William F., Seehofer, Daniel, Settmacher, Utz, Sánchez-Bueno, Francisco, Prous, Joan Fabregat, Boleslawski, Emmanuel, Friman, Styrbjörn, Porte, Robert J., Lehner, Frank, Klempnauer, Jurgen, Ericzon, Bo-Göran, Croner, Roland, Pratschke, Johann, Sucher, Robert, Kaiser, Gernot Maximil, Muscari, Fabrice, Fourtanier, Gilles, Mazzaferro, Vincenzo, Citterio, Davide, Salizzoni, Mauro, Troisi, Roberto, Haantjes, Ivo, Gugenheim, Jean, Laurent, Alexis, Stippel, Dirk, Krawczyk, Marek, Isoniemi, Helena, and Groningen Institute for Organ Transplantation (GIOT)
- Subjects
Male ,medicine.medical_treatment ,Medizin ,Cancer Treatment ,lcsh:Medicine ,Trasplantament hepàtic ,Liver transplantation ,Cholangiocarcinoma ,0302 clinical medicine ,Medicine and Health Sciences ,Registries ,lcsh:Science ,OUTCOMES ,Multidisciplinary ,Pharmaceutics ,Chemoradiotherapy ,Middle Aged ,Tumor Resection ,Survival Rate ,Klatskin tumor ,Surgical Oncology ,Oncology ,030220 oncology & carcinogenesis ,Female ,030211 gastroenterology & hepatology ,Anatomy ,Liver cancer ,Research Article ,Hepatic Resection ,Clinical Oncology ,Adult ,medicine.medical_specialty ,RESECTION ,PERIHILAR CHOLANGIOCARCINOMA ,Radiation Therapy ,Surgical and Invasive Medical Procedures ,Disease-Free Survival ,Lymphatic System ,Càncer de fetge ,Digestive System Procedures ,03 medical and health sciences ,Drug Therapy ,Gastrointestinal Tumors ,medicine ,Chemotherapy ,Humans ,Survival rate ,Transplantation ,Surgical Resection ,business.industry ,Patient Selection ,lcsh:R ,Cancers and Neoplasms ,Biology and Life Sciences ,Retrospective cohort study ,Organ Transplantation ,medicine.disease ,Liver Transplantation ,Surgery ,Radiation therapy ,Clinical trial ,Bile Duct Neoplasms ,600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::617 Chirurgie und verwandte medizinische Einrichtungen ,lcsh:Q ,Lymph Nodes ,Clinical Medicine ,Hepatic transplantation ,business ,Combination Chemotherapy ,Follow-Up Studies ,Klatskin Tumor - Abstract
Liver transplantation for hilar cholangiocarcinoma (hCCA) has regained attention since the Mayo Clinic reported their favorable results with the use of a neo-adjuvant chemoradiation protocol. However, debate remains whether the success of the protocol should be attributed to the neo-adjuvant therapy or to the strict selection criteria that are being applied. The aim of this study was to investigate the value of patient selection alone on the outcome of liver transplantation for hCCA. In this retrospective study, patients that were transplanted for hCCA between1990 and 2010 in Europe were identified using the European Liver Transplant Registry (ELTR). Twenty-one centers reported 173 patients (69%) of a total of 249 patients in the ELTR. Twenty-six patients were wrongly coded, resulting in a study group of 147 patients. We identified 28 patients (19%) who met the strict selection criteria of the Mayo Clinic protocol, but had not undergone neo-adjuvant chemoradiation therapy. Five-year survival in this subgroup was 59%, which is comparable to patients with pretreatment pathological confirmed hCCA that were transplanted after completion of the chemoradiation protocol at the Mayo Clinic. In conclusion, although the results should be cautiously interpreted, this study suggests that with strict selection alone, improved survival after transplantation can be achieved, approaching the Mayo Clinic experience. OA gold
- Published
- 2016