Komaya K, et al. - In resected perihilar cholangiocarcinoma, researchers investigated recurrence after resection and evaluated prognostic factors on the time to recurrence and recurrence-free survival. Recurrence after R0 resection was observed in more than half of patients with perihilar cholangiocarcinoma. As per findings, these recurrences occur frequently within 5 years but occasionally after 5 years. This highlighted the significance of close and long-term surveillance. They recommended considering adjuvant strategies, especially for patients with nodal metastasis or venous invasion even after R0 resection.

Methods

• Researchers retrospectively reviewed consecutive patients who underwent curative-intent resection of perihilar cholangiocarcinoma between 2001 and 2012.
• For multivariable analysis, they used the Cox proportional hazards model.

Results

• Resection of perihilar cholangiocarcinoma was performed on 402 patients (R0, n = 340; R1, n = 62).
• The most common reason for R1 resection included radial margin positivity (n = 43, 69%).
• The survivors were followed-up for a median period of 7.4 years.
• R1 compared to R0 resection showed higher cumulative recurrence probability (86% vs 57% at 5 years, P < .001).
• Over 5 years, 17 R0 patients had a recurrence after resection.
• Findings suggested no difference in median survival time after recurrence between R0 and R1 resection (10 vs 7 months).
• R1 compared to R0 resection had higher proportion of isolated locoregional recurrence (37% vs 16%, P < .001), whereas the proportion of distant recurrence was similar.
• The independent prognostic factors for time to recurrence and recurrence-free survival in R0 resection included microscopic venous invasion and lymph node metastasis.