Tumour size over 3 cm predicts poor short-term outcomes after major liver resection for hilar cholangiocarcinoma. By the HC-AFC-2009 group
Jean-Marc Régimbeau
(1)
,
David Fuks
(1)
,
Patrick Pessaux
(2)
,
Philippe Bachellier
(2)
,
Denis Chatelain
(1)
,
Momar Diouf
(1)
,
Artigas Raventos
,
Georges Mantion
(3)
,
Jean-Francois Gigot
,
Laurence Chiche
(4)
,
Gérard Pascal
(5)
,
Daniel Azoulay
(5)
,
Alexis Laurent
(6)
,
Christian Letoublon
(7)
,
Emmanuel Boleslawski
(8)
,
Michel Rivoire
(9)
,
Jean-Yves Mabrut
(10)
,
Mustapha Adham
(11)
,
Yves-Patrice Le Treut
(12)
,
Jean-Robert Delpero
(13)
,
Francis Navarro
(14, 15)
,
Ahmet Ayav
(16)
,
Karim Boudjema
(17)
,
Gennaro Nuzzo
,
Michel Scotté
(18)
,
Olivier Farges
(19)
1
CHU Amiens-Picardie
2 CHU Strasbourg - Centre Hospitalier Universitaire [Strasbourg]
3 CHRU Besançon - Centre Hospitalier Régional Universitaire de Besançon
4 Service de Chirurgie Viscérale et Digestive [CHU Caen]
5 Hôpital Paul Brousse
6 Hôpital Henri Mondor
7 Département de chirurgie digestive et de l'urgence
8 Hôpital Claude Huriez [Lille]
9 Centre Léon Bérard [Lyon]
10 Hôpital de la Croix-Rousse [CHU - HCL]
11 Hôpital Edouard Herriot [CHU - HCL]
12 IPC - Institut Paoli-Calmettes
13 LA CONCEPTION - Hôpital de la Conception [CHU - APHM]
14 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
15 Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB)
16 Service de Chirurgie Digestive Hépatobiliaire et Endocrine [CHRU Nancy]
17 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
18 Service de Chirurgie Digestive [CHU Rouen]
19 Hôpital Beaujon
2 CHU Strasbourg - Centre Hospitalier Universitaire [Strasbourg]
3 CHRU Besançon - Centre Hospitalier Régional Universitaire de Besançon
4 Service de Chirurgie Viscérale et Digestive [CHU Caen]
5 Hôpital Paul Brousse
6 Hôpital Henri Mondor
7 Département de chirurgie digestive et de l'urgence
8 Hôpital Claude Huriez [Lille]
9 Centre Léon Bérard [Lyon]
10 Hôpital de la Croix-Rousse [CHU - HCL]
11 Hôpital Edouard Herriot [CHU - HCL]
12 IPC - Institut Paoli-Calmettes
13 LA CONCEPTION - Hôpital de la Conception [CHU - APHM]
14 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
15 Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB)
16 Service de Chirurgie Digestive Hépatobiliaire et Endocrine [CHRU Nancy]
17 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
18 Service de Chirurgie Digestive [CHU Rouen]
19 Hôpital Beaujon
Jean-Marc Régimbeau
- Fonction : Auteur
- PersonId : 1078724
- ORCID : 0000-0001-7631-9112
- IdRef : 076392481
Patrick Pessaux
- Fonction : Auteur
- PersonId : 1059086
- ORCID : 0000-0001-5635-7437
- IdRef : 06911014X
Artigas Raventos
- Fonction : Auteur
Jean-Francois Gigot
- Fonction : Auteur
Alexis Laurent
- Fonction : Auteur
- PersonId : 766402
- ORCID : 0000-0003-1372-0843
- IdRef : 059911824
Jean-Robert Delpero
- Fonction : Auteur
- PersonId : 764859
- ORCID : 0000-0002-0000-1332
- IdRef : 060900326
Ahmet Ayav
- Fonction : Auteur
- PersonId : 762396
- IdRef : 09518399X
Gennaro Nuzzo
- Fonction : Auteur
Résumé
INTRODUCTION:
As mortality and morbidity after a curative resection remains high, it is essential to identify pre-operative factors associated with an early death after a major resection.
METHODS:
Between 1998 and 2008, we selected a population of 331 patients having undergone a major hepatectomy including segment I with a lymphadenectomy and a common bile duct resection for a proven hilar cholangiocarcinoma in 21 tertiary centres. The study's objective was to identify pre-operative predictors of early death (<12 months) after a resection.
RESULTS:
The study cohort consisted of 221 men and 110 women, with a median age of 61 years (range: 24-85). The post-operative mortality and morbidity rates were 8.2% and 61%, respectively. The 1-, 3- and 5-year overall survival rates were 85%, 64% and 53%, respectively. The median tumour size was 23 mm on pathology, ranging from 8 to 40. A tumour size >30 mm [odds ratio (OR) 2.471 (95% confidence interval (CI) 1.136-7.339), P = 0.001] and major post-operative complication [OR 3.369 (95% CI 1.038-10.938), P = 0.004] were independently associated with death <12 months in a multivariate analysis.
CONCLUSION:
The present analysis of a series of 331 patients with hilar cholangiocarcinoma showed that tumour size >30 mm was independently associated with death <12 months.