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Liver transplantation for hilar cholangiocarcinoma: a German survey.

Abstract：

BACKGROUND:The present study reports a German survey addressing outcomes in nonselected historical series of liver transplantation (OLT) for hilar cholangiocarcinoma (HL). PATIENTS AND METHODS:We sent to all 25 German transplant centers performing OLT a survey that addressed (1) the number of OLTs for HL and the period during which they were performed; (2) the incidence of HL diagnosed prior to OLT/rate of incidental HL (for example, in primary sclerosing cholangitis); (3) tumor stages according to Union Internationale Centre le Cancer; (4) patient survival; and (5) tumor recurrence rate. RESULTS:Eighty percent of centers responded, reporting 47 patients who were transplanted for HL. Tumors were classified as pT2 (25%), pT3 (73%), or pT4 (2%). HL was diagnosed incidentally in 10% of cases. A primary diagnosis of PSC was observed in 16% of patients. Overall median survival was 35.5 months. When in-hospital mortality (n = 12) was excluded, the median survival was 45.4 months, corresponding to 3- and 5-year survival rates of 42% and 31%, versus 31% and 22% when in-hospital mortality was included. HL recurred in 34% of cases. Three- and 5-year survivals for the 15 patients transplanted since 1998 was 57% and 48%, respectively. Median survival ranged from 20 to 42 months based on the time period (P = .014). CONCLUSIONS:The acceptable overall survival, the improved results after careful patient selection since 1998, and the encouraging outcomes from recent studies all suggest that OLT may be a potential treatment for selected cases of HL. Prospective multicenter randomized studies with strict selection criteria and multimodal treatments seem necessary.

journal_name

Transplant Proc

journal_title

Transplantation proceedings

authors

Kaiser GM,Sotiropoulos GC,Jauch KW,Löhe F,Hirner A,Kalff JC,Königsrainer A,Steurer W,Senninger N,Brockmann JG,Schlitt HJ,Zülke C,Büchler MW,Schemmer P,Settmacher U,Hauss J,Lippert H,Hopt UT,Otto G,Heiss MM,Bechste

doi

10.1016/j.transproceed.2008.08.039

subject

Has Abstract

pub_date

2008-11-01 00:00:00

pages

3191-3

issue

9

eissn

0041-1345

issn

1873-2623

pii

S0041-1345(08)01117-2

journal_volume

40

pub_type

杂志文章,多中心研究

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