Papillary phenotype confers improved survival after resection of hilar cholangiocarcinoma

William R. Jarnagin, Wilbur Bowne, David S. Klimstra, Leah Ben-Porat, Kevin Roggin, Karina Cymes, Yuman Fong, Ronald P. DeMatteo, Michael D'Angelica, Jonathan Koea, Leslie H. Blumgart, William Chapman, Steven C. Stain, Henry A. Pitt, Alan W. Hemming, Reid B. Adams, Bryan M. Clary

Research output: Contribution to journalArticle


Objective: The current study compares outcome after resection of papillary hilar cholangiocarcinoma to that of the more common nodular-sclerosing subtype. Methods: Clinical, radiologic, histopathologic, and survival data on all patients with hilar cholangiocarcinoma were analyzed. Resected tumors were reexamined and classified as nodular-sclerosing (no component of papillary carcinoma) or papillary (any component of papillary carcinoma); for papillary tumors, the proportion of invasive carcinoma present was determined. Differences in the clinical behavior and histopathologic features of nodular-sclerosing and papillary tumors were assessed. Results: From January 1991 to November 2003, 279 patients were evaluated, 154 men (55.2%) and 125 women (44.8%), with a mean age of 65.4 ± 0.7 years (median = 68, range 23-87 years). Of the 215 patients explored, 106 (49.5%) underwent a complete gross resection. An en bloc partial hepatectomy (n = 87) and an RO resection (n = 82) were independent predictors of favorable outcome. Operative mortality was 7.5% but was 2.8% over the last 4 years of the study, and there were no operative deaths in the last 33 consecutive resections. Twenty-five resected tumors (23.6%) contained a papillary component: 12 were minimally or noninvasive (

Original languageEnglish (US)
Pages (from-to)703-714
Number of pages12
JournalAnnals of Surgery
Issue number5
StatePublished - May 2005
Externally publishedYes


ASJC Scopus subject areas

  • Surgery

Cite this

Jarnagin, W. R., Bowne, W., Klimstra, D. S., Ben-Porat, L., Roggin, K., Cymes, K., Fong, Y., DeMatteo, R. P., D'Angelica, M., Koea, J., Blumgart, L. H., Chapman, W., Stain, S. C., Pitt, H. A., Hemming, A. W., Adams, R. B., & Clary, B. M. (2005). Papillary phenotype confers improved survival after resection of hilar cholangiocarcinoma. Annals of Surgery, 241(5), 703-714.