Background: The aim of this study was to compare patients with PHC with lymph node metastases (LN+) who underwent a resection with patients who did not undergo resection because of locally advanced disease at exploratory laparotomy.
Methods: Consecutive LN+ patients who underwent a resection for PHC in 12 centers were compared with patients who did not undergo resection because of locally advanced disease at exploratory laparotomy in 2 centers.
Results: In the resected cohort of 119 patients, the median overall survival (OS) was 19 months and the estimated 1-, 3- and 5-year OS was 69%, 27% and 13%, respectively. In the non-resected cohort of 113 patients, median OS was 12 months and the estimated 1-, 3- and 5-year OS was 49%, 7%, and 3%, respectively. OS was better in the resected LN+ cohort (p < 0.001). Positive resection margin (hazard ratio [HR]: 1.54; 95%CI: 0.97-2.45) and lymphovascular invasion (LVI) (HR: 1.71; 95%CI: 1.09-2.69) were independent poor prognostic factors in the resected cohort.
Conclusion: Patients with PHC who underwent a resection for LN+ disease had better OS than patients who did not undergo resection because of locally advanced disease at exploratory laparotomy. LN+ PHC does not preclude 5-year survival after resection.

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Persistent URL dx.doi.org/10.1016/j.hpb.2017.04.014, hdl.handle.net/1765/100083
Journal HPB
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Citation
Büttner, S, van Vugt, J.L.A, Gaspersz, M.P, Coelen, R.J, Roos, E. (Eva), Labeur, T.A. (Tim A.), … Groot Koerkamp, B. (2017). Survival after resection of perihilar cholangiocarcinoma in patients with lymph node metastases. HPB, 19(8), 735–740. doi:10.1016/j.hpb.2017.04.014