Correlation of staging systems to survival in patients with resected hilar cholangiocarcinoma

Am J Surg. 2013 Aug;206(2):159-65. doi: 10.1016/j.amjsurg.2012.11.020. Epub 2013 Jun 6.

Abstract

Background: We aimed to identify staging parameters associated with survival in patients with hilar cholangiocarcinoma.

Methods: Clinicopathologic characteristics were obtained retrospectively for all resected patients with Bismuth-Corlette III cholangiocarcinoma between 1993 and 2011. Patients were stratified by the American Joint Commission on Cancer (AJCC) (7th edition) and Memorial Sloan-Kettering Cancer Center (MSKCC) staging systems. Survival analyses tested the effects of clinicopathologic factors and staging covariates on recurrence-free and overall survival.

Results: Eighty patients (mean age 63 ± 11 years, 63% male) underwent anatomic hepatectomy with bile duct resection/reconstruction for Bismuth-Corlette IIIa (53%) and IIIb (47%) cholangiocarcinoma. The median follow-up was 26 months (interquartile range = 12 to 50 months), and the median time to recurrence was 15 months (interquartile range = 6 to 38 months). Neither AJCC nor MSKCC staging systems were associated with recurrence-free survival (all P ≥ .059). MSKCC T-stage but not the AJCC staging system was associated with overall survival (P ≤ .026).

Conclusions: MSKCC T-stage classification but not AJCC staging is independently associated with overall survival for patients after resection of hilar cholangiocarcinoma.

Keywords: American Joint Commission on Cancer stage; Bismuth-Corlette; Hilar cholangiocarcinoma; Memorial Sloan-Kettering Cancer Center stage; Survival.

MeSH terms

  • Aged
  • Analysis of Variance
  • Bile Duct Neoplasms / mortality*
  • Bile Duct Neoplasms / pathology*
  • Bile Duct Neoplasms / surgery
  • Bile Ducts, Intrahepatic* / pathology
  • Bile Ducts, Intrahepatic* / surgery
  • Cholangiocarcinoma / mortality*
  • Cholangiocarcinoma / pathology*
  • Cholangiocarcinoma / surgery
  • Disease-Free Survival
  • Female
  • Hepatectomy* / methods
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Neoplasm Grading
  • Neoplasm Staging / methods*
  • Predictive Value of Tests
  • Prognosis
  • Proportional Hazards Models
  • Retrospective Studies