Management of Proximal cholangiocarcinomas by surgical resection and radiotherapy

John L Cameron, Henry A. Pitt, Michael J. Zinner, Steven L. Kaufman, JoAnn Coleman

Research output: Contribution to journalArticle

Abstract

Ninety-six patients with proximal cholangiocarcinomas were managed surgically. Fifty-three patients (55 percent) were resected, 39 curatively (41 percent), and 43 (45 percent) underwent palliative stenting. The preoperative placement of Ring catheters and the operative use of silastic transhepatic biliary stents greatly facilitated the surgical management of these lesions. Sixty-three patients (66 percent) also received postoperative radiotherapy. Hospital mortality was 4 percent (four deaths). Hospital mortality was 2 percent after resection (1 of 53 patients) and 7 percent after palliative stenting (3 of 43 patients). All deaths resulted from sepsis. One, 3, 5, and 10-year survivals for the entire group were 49 percent, 12 percent, 5 percent, and 2 percent, respectively. One, 3, 5, and 10-year survivals in the resected group (66 percent, 21 percent, 8 percent, and 4 percent, respectively) were superior to those in the stented group (27 percent, 6 percent, 0 percent, and 0 percent, respectively). Radiotherapy appeared to significantly extend survival in those patients undergoing palliative stenting, but not in those undergoing resection. We conclude that surgical resection of proximal cholangiocarcinomas can be performed safely and that it significantly prolongs survival. Further improvement in long-term survival will depend on advances in adjuvant therapy.

Original languageEnglish (US)
Pages (from-to)91-98
Number of pages8
JournalAmerican Journal of Surgery
Volume159
Issue number1
DOIs
StatePublished - 1990
Externally publishedYes

Fingerprint

Cholangiocarcinoma
Radiotherapy
Survival
Hospital Mortality
Stents
Sepsis
Catheters

ASJC Scopus subject areas

  • Surgery

Cite this

Management of Proximal cholangiocarcinomas by surgical resection and radiotherapy. / Cameron, John L; Pitt, Henry A.; Zinner, Michael J.; Kaufman, Steven L.; Coleman, JoAnn.

In: American Journal of Surgery, Vol. 159, No. 1, 1990, p. 91-98.

Research output: Contribution to journalArticle

Cameron, John L ; Pitt, Henry A. ; Zinner, Michael J. ; Kaufman, Steven L. ; Coleman, JoAnn. / Management of Proximal cholangiocarcinomas by surgical resection and radiotherapy. In: American Journal of Surgery. 1990 ; Vol. 159, No. 1. pp. 91-98.
@article{5509bde046b24c18ab81c45276c01e25,
title = "Management of Proximal cholangiocarcinomas by surgical resection and radiotherapy",
abstract = "Ninety-six patients with proximal cholangiocarcinomas were managed surgically. Fifty-three patients (55 percent) were resected, 39 curatively (41 percent), and 43 (45 percent) underwent palliative stenting. The preoperative placement of Ring catheters and the operative use of silastic transhepatic biliary stents greatly facilitated the surgical management of these lesions. Sixty-three patients (66 percent) also received postoperative radiotherapy. Hospital mortality was 4 percent (four deaths). Hospital mortality was 2 percent after resection (1 of 53 patients) and 7 percent after palliative stenting (3 of 43 patients). All deaths resulted from sepsis. One, 3, 5, and 10-year survivals for the entire group were 49 percent, 12 percent, 5 percent, and 2 percent, respectively. One, 3, 5, and 10-year survivals in the resected group (66 percent, 21 percent, 8 percent, and 4 percent, respectively) were superior to those in the stented group (27 percent, 6 percent, 0 percent, and 0 percent, respectively). Radiotherapy appeared to significantly extend survival in those patients undergoing palliative stenting, but not in those undergoing resection. We conclude that surgical resection of proximal cholangiocarcinomas can be performed safely and that it significantly prolongs survival. Further improvement in long-term survival will depend on advances in adjuvant therapy.",
author = "Cameron, {John L} and Pitt, {Henry A.} and Zinner, {Michael J.} and Kaufman, {Steven L.} and JoAnn Coleman",
year = "1990",
doi = "10.1016/S0002-9610(05)80612-9",
language = "English (US)",
volume = "159",
pages = "91--98",
journal = "American Journal of Surgery",
issn = "0002-9610",
publisher = "Elsevier Inc.",
number = "1",

}

TY - JOUR

T1 - Management of Proximal cholangiocarcinomas by surgical resection and radiotherapy

AU - Cameron, John L

AU - Pitt, Henry A.

AU - Zinner, Michael J.

AU - Kaufman, Steven L.

AU - Coleman, JoAnn

PY - 1990

Y1 - 1990

N2 - Ninety-six patients with proximal cholangiocarcinomas were managed surgically. Fifty-three patients (55 percent) were resected, 39 curatively (41 percent), and 43 (45 percent) underwent palliative stenting. The preoperative placement of Ring catheters and the operative use of silastic transhepatic biliary stents greatly facilitated the surgical management of these lesions. Sixty-three patients (66 percent) also received postoperative radiotherapy. Hospital mortality was 4 percent (four deaths). Hospital mortality was 2 percent after resection (1 of 53 patients) and 7 percent after palliative stenting (3 of 43 patients). All deaths resulted from sepsis. One, 3, 5, and 10-year survivals for the entire group were 49 percent, 12 percent, 5 percent, and 2 percent, respectively. One, 3, 5, and 10-year survivals in the resected group (66 percent, 21 percent, 8 percent, and 4 percent, respectively) were superior to those in the stented group (27 percent, 6 percent, 0 percent, and 0 percent, respectively). Radiotherapy appeared to significantly extend survival in those patients undergoing palliative stenting, but not in those undergoing resection. We conclude that surgical resection of proximal cholangiocarcinomas can be performed safely and that it significantly prolongs survival. Further improvement in long-term survival will depend on advances in adjuvant therapy.

AB - Ninety-six patients with proximal cholangiocarcinomas were managed surgically. Fifty-three patients (55 percent) were resected, 39 curatively (41 percent), and 43 (45 percent) underwent palliative stenting. The preoperative placement of Ring catheters and the operative use of silastic transhepatic biliary stents greatly facilitated the surgical management of these lesions. Sixty-three patients (66 percent) also received postoperative radiotherapy. Hospital mortality was 4 percent (four deaths). Hospital mortality was 2 percent after resection (1 of 53 patients) and 7 percent after palliative stenting (3 of 43 patients). All deaths resulted from sepsis. One, 3, 5, and 10-year survivals for the entire group were 49 percent, 12 percent, 5 percent, and 2 percent, respectively. One, 3, 5, and 10-year survivals in the resected group (66 percent, 21 percent, 8 percent, and 4 percent, respectively) were superior to those in the stented group (27 percent, 6 percent, 0 percent, and 0 percent, respectively). Radiotherapy appeared to significantly extend survival in those patients undergoing palliative stenting, but not in those undergoing resection. We conclude that surgical resection of proximal cholangiocarcinomas can be performed safely and that it significantly prolongs survival. Further improvement in long-term survival will depend on advances in adjuvant therapy.

UR - http://www.scopus.com/inward/record.url?scp=0025062475&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0025062475&partnerID=8YFLogxK

U2 - 10.1016/S0002-9610(05)80612-9

DO - 10.1016/S0002-9610(05)80612-9

M3 - Article

VL - 159

SP - 91

EP - 98

JO - American Journal of Surgery

JF - American Journal of Surgery

SN - 0002-9610

IS - 1

ER -