Surgery for Bismuth-Corlette Type 4 Perihilar Cholangiocarcinoma: Results from a Western Multicenter Collaborative Group

• DOI: 10.1245/s10434-021-09905-z
• Publication Date: 2021-05-06T14:05:19Z
• Authors: Andrea Ruzzenente; Fabio Bagante; Pim B. Olthof; Luca Aldrighetti; Ruslan Alikhanov; Matteo Cescon; Bas Groot Koerkamp; William R. Jarnagin; Silvio Nadalin; Johann Pratschke; Moritz Schmelzle; Ernesto Sparrelid; Hauke Lang; Calogero Iacono; Thomas M. van Gulik; Alfredo Guglielmi; ; A. Andreou; F. Bartsch; C. Benzing; S. Buettner; T. Campagnaro; I. Capobianco; R. Charco; P. de Reuver; E. de Savornin Lo...; C. H. C. Dejong; M. Efanov; J. I. Erdmann; L. C. Franken; G. Giovinazzo; M. C. Giglio; C. Gomez-Gavara; F. Heid; J. N. M. IJzermans; J. Isaac; H. Jansson; M. A. P. Ligthart; S. K. Maithel; M. Malagò; H. Z. Malik; P. Muiesan; S. W. M. Olde Damink; L. M. Quinn; F. Ratti; M. Ravaioli; J. Rolinger; E. Schadde; M. Serenari; R. Troisi; S. van Laarhoven; J. L. A. van Vugt
• Keywords: Surgical oncology

Although Bismuth-Corlette (BC) type 4 perihilar cholangiocarcinoma (pCCA) is no longer considered a contraindication for curative surgery, few data are available from Western series to indicate the outcomes these patients. This study aimed compare short- and long-term patients with BC versus types 2 3 pCCA undergoing surgical resection using multi-institutional international database.Uni- multivariable analyses of surgery at 20 centers pCCA.Among 1138 included in study, 826 (73%) had or disease 312 (27%) disease. The two groups demonstrated significant differences terms clinicopathologic characteristics (i.e., portal vein embolization, extended hepatectomy, positive margin). incidence severe complications was 46% 51% (p = 0.1). Moreover, 90-day mortality 13% 12% 0.57). Lymph-node metastasis (N1; hazard-ratio [HR], 1.62), margins (R1; HR, 1.36), perineural invasion (HR, 1.53), poor grade differentiation 1.25) were predictors survival (all p ≤0.004), but not associated prognosis. Among N0 R0 patients, 5-year overall 43% 41% those 0.60).In this analysis large cohort, shown be an acceptable treatment option selected although more technically challenging approach required.