Predictors of long term survival after hepatic resection for hilar cholangiocarcinoma: A retrospective study of 5-year survivors

Table 1 Baseline characteristics n (%)

	< 5-yr survival (n = 209)	> 5-yr survival (n = 34)	P value
Age	54.59 ± 4.98	50.47 ± 4.45	0.001
Sex
Male	124 (59.3)	23 (67.6)	0.09
Female	85 (40.7)	11 (32.4)
Symptoms
Pain	73 (34.9)	12 (35.3)	0.97
Jaundice	206 (98.6)	34 (100)	0.95
Weight loss	97 (46.4)	13 (38.2)	0.349
Serum albumin	3.7 (± 0.46)	3.82 (± 0.31)	0.162
Total serum bilirubin	15.29 (± 9.74)	15.13 (± 9.41)	0.928
Serum alkaline phosphatase	29.92 (± 41.62)	38.74 (± 24.12)	0.231
SGPT	97.33 (± 112.84)	89.18 (± 52.74)	0.68
CA19-9	395.71 ± 31.43	254.06 ± 42.19	< 0.0001
HCV	86 (41.1)	10 (29.4)	0.18
Preoperative biliary drainage	90 (43.06)	18 (52.9)	0.38
No preoperative biliary drainage	119 (66.94)	16 (47.1)
ERCP	25 (11.96)	9 (26.5)	0.025
PTD	65 (31.1)	9 (26.5)	0.564

HCV: Hepatitis C virus; ERCP: Endoscopic retrograde cholangiopancreatography; SGPT: Serum glutamic-pyruvic transaminase; PTD: Preoperative biliary drainage.

Table 2 Operative data n (%)

	< 5-yr survival	> 5-yr survival	P value
Liver status			0.02
Cirrhotic (n = 102)	97 (46.41)	5 (14.7)
Non-cirrhotic (n = 141)	112 (53.58)	29 (85.29)
Bismuth corlette classification			0.68
Types I and II	63 (30.14)	11 (32.35)
Type III	146 (69.85)	23 (67.64)
Type IV	0	0
Extent of hepatic resection
Type of resection			0.001
Localized resection (n = 70)	66 (31.57)	4 (11.76)
Major resection (n = 173)	143 (68.42)	30 (88.23)
Type of major resection			0.07
Lt hepatectomy (n = 102)	81 (38.75)	21 (61.76)
Rt hepatectomy (n = 71)	62 (29.66)	9 (26.47)
Segment 1 resection	79 (37.79)	23 (67.64)	0.006
Number of anastomosis			0.85
Single	86 (41.14)	18 (52.9)
Multiple	123 (58.85)	16 (47.1)
Blood transfusion			0.91
< 3 units	149 (71.3)	24 (70.58)
≥ 3 units	60 (28.7)	10 (29.41)
Operative time	4.28	4.28	0.75

Table 3 Postoperative data n (%)

	< 5-yr survival	> 5-yr survival	P value
Hospital stay	13	11.78	0.33
Bile leakage	75 (35.88)	7 (20.0)	0.08
Wound infection	50 (23.9)	6 (17.6)	0.39
Early LCF	38 (18.18)	1 (2.9)	0.023
Collection	38 (18.18)	6 (17.6)	0.94
Bleeding and fistula	13 (6.2)	1 (2.9)	0.42
Lymph node metastasis	81 (41.8)	6 (17.6)	0.008
Histological grade			0.033
Well differentiated	78 (37.32)	20 (58.82)
Moderately differentiated	83 (39.71)	11 (32.35)
Poorly differentiated	48 (23.0)	3 (8.82)
Safety margin			< 0.0001
R0	93 (44.5%)	28 (82.35)
R1	116 (55.5)	6 (17.6)
Recurrence			0.88
Hepatic recurrence	51 (24.4)	8 (23.52)
Local recurrence	27 (12.9)	6 (17.64)
Late LCF	51 (51.5)	8 (33.3)	0.11

LCF: Liver cell failure.

Table 4 Multivariate cox regression after resection of hilar cholangiocarcinoma

Variable	P value	Oddis ratio	95%CI for Exp (B)
			Lower	Upper
Liver status	0.000	11.78	5.271	26.327
Safety margin	0.000	4.937	2.251	10.826
Type of resection	0.984	1.006	0.564	1.795
Caudate lobe resection	0.000	3.808	1.878	7.725
Lymph node status	0.000	0.08	0.029	0.217
Tumour differentiation	0.265	0.819	0.577	1.164
Age	0.055	1.04	0.999	1.084
Early LCF	0.367	1.415	0.666	3.003
CA19-9	0.000	1.01	1.005	1.015

LCF: Liver cell failure.