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Analysis of Patients With Incidental Perihilar Cholangiocarcinoma: An Old and a Persistent Burden for Liver Transplantation.
- Source :
-
Transplantation proceedings [Transplant Proc] 2020 Oct; Vol. 52 (8), pp. 2507-2511. Date of Electronic Publication: 2020 Apr 17. - Publication Year :
- 2020
-
Abstract
- Background: Selected patients with unresectable perihilar cholangiocarcinoma (p-CCA) are now considered as candidates for liver transplant, provided they fulfill a strict perioperative treatment and staging protocol. The aim of this study was to examine the outcomes of patients after liver transplant with incidental p-CCA found in the liver explants.<br />Methods: A cohort of 10 patients with incidental p-CCA after liver transplant in the period between 1994 and 2019 was included in this retrospective analysis. All patients with this diagnosis were scheduled for transplant because of primary sclerosing cholangitis. The primary and secondary endpoints comprised patient's death and tumor recurrence, respectively, assessed over a 5-year postoperative period.<br />Results: Patient median age was 35 years (range, 32-42 years). Median size of the tumor was 3.0 cm (range, 2.5-4.0 cm). Five patients (50%) had metastases to local lymph nodes. Overall survival was 100%, 37.5%, and 18.8% after the first, third, and fifth postoperative year, respectively, with median survival of 21 months. Patient age (P = .827), R1 resection status (P = .144), tumor diameter (P = .432), and presence of lymph node metastases (P = .663) were not significantly associated with overall survival. Recurrence-free survival was 60.0% after the first postoperative year and 22.5% after the third and fifth postoperative years, with median recurrence-free survival of 13.6 months. No significant predictors of tumor recurrence were found.<br />Conclusions: Incidental p-CCA in patients with primary sclerosing cholangitis undergoing liver transplant is associated with universally very high risk of postoperative tumor recurrence and short expected survival.<br /> (Copyright © 2020 Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Bile Duct Neoplasms mortality
Bile Duct Neoplasms pathology
Bile Duct Neoplasms surgery
Bile Ducts, Intrahepatic pathology
Cholangitis, Sclerosing mortality
Cholangitis, Sclerosing surgery
Female
Humans
Incidental Findings
Klatskin Tumor mortality
Klatskin Tumor pathology
Male
Neoplasm Recurrence, Local mortality
Neoplasm Recurrence, Local pathology
Retrospective Studies
Bile Duct Neoplasms complications
Cholangitis, Sclerosing complications
Klatskin Tumor complications
Liver Transplantation methods
Liver Transplantation mortality
Neoplasm Recurrence, Local epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1873-2623
- Volume :
- 52
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Transplantation proceedings
- Publication Type :
- Academic Journal
- Accession number :
- 32307142
- Full Text :
- https://doi.org/10.1016/j.transproceed.2020.02.094