Outcome after resection for perihilar cholangiocarcinoma in patients with primary sclerosing cholangitis: an international multicentre study

Hannes Jansson*, Pim B Olthof, Perihilar Cholangiocarcinoma Collaboration Group, Annika Bergquist, Marjolein A P Ligthart, Silvio Nadalin, Roberto I Troisi, Bas Groot Koerkamp, Ruslan Alikhanov, Hauke Lang, Alfredo Guglielmi, Matteo Cescon, William R Jarnagin, Luca Aldrighetti, Thomas M van Gulik, Ernesto Sparrelid

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

BACKGROUND: Resection for perihilar cholangiocarcinoma (pCCA) in primary sclerosing cholangitis (PSC) has been reported to lead to worse outcomes than resection for non-PSC pCCA. The aim of this study was to compare prognostic factors and outcomes after resection in patients with PSC-associated pCCA and non-PSC pCCA.

METHODS: The international retrospective cohort comprised patients resected for pCCA from 21 centres (2000-2020). Patients operated with hepatobiliary resection, with pCCA verified by histology and with data on PSC status, were included. The primary outcome was overall survival. Secondary outcomes were disease-free survival and postoperative complications.

RESULTS: Of 1128 pCCA patients, 34 (3.0%) had underlying PSC. Median overall survival after resection was 33 months for PSC patients and 29 months for non-PSC patients (p = .630). Complications (Clavien-Dindo grade ≥ 3) were more frequent in PSC pCCA (71% versus 44%, p = .003). The rate of posthepatectomy liver failure (21% versus 17%, p = .530) and 90-day mortality (12% versus 13%, p = 1.000) was similar for PSC and non-PSC patients.

CONCLUSION: Median overall survival after resection for pCCA was similar in patients with underlying PSC and non-PSC patients. Complications were more frequent after resection for PSC-associated pCCA, with no difference in postoperative mortality.

Original languageEnglish
Pages (from-to)1751-1758
Number of pages8
JournalHPB
Volume23
Issue number11
DOIs
Publication statusPublished - 1 Nov 2021

Bibliographical note

Funding:
Hannes Jansson was supported by grants from the Royal Swedish Academy of Sciences and Region Stockholm . Ernesto Sparrelid was supported by grants from the Bengt Ihre Foundation , the Center for Innovative Medicine at Karolinska Institutet and Region Stockholm. The funding sources had no involvement in the design or conduct of the study, the writing of the report or the decision to submit the article for publication.

Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.

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