LIVER TRANSPLANTATION FOR CHOLANGIOCARCINOMA: RESULTS IN 207 PATIENTS1
- 1 April 2000
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Transplantation
- Vol. 69 (8), 1633-1637
- https://doi.org/10.1097/00007890-200004270-00019
Abstract
Because of the high incidence of recurrent tumor, many surgeons have become disenchanted with transplantation as a treatment for cholangiocarcinoma. The Cincinnati Transplant Tumor Registry database was used to examine 207 patients who underwent liver transplantation for otherwise unresectable cholangiocarcinoma or cholangiohepatoma. Specific factors evaluated included tumor size, presence of multiple nodules, evidence of tumor spread at surgery, and treatment with adjuvant chemotherapy and/or radiation therapy. Incidentally found tumors were compared to tumors that were known or suspected to be present before transplantation. The 1, 2, and 5-year survival estimates using life table analysis were 72, 48, and 23%. Fifty-one percent of patients had recurrence of their tumors after transplantation and 84% of recurrences occurred within 2 years of transplantation. Survival after recurrence was rarely more than 1 year. Forty-seven percent of recurrences occurred in the allograft and 30% in the lungs. Tumor recurrence, and evidence of tumor spread at the time of surgery, were negative prognostic variables. There were no positive prognostic variables. Patients with incidentally found cholangiocarcinomas did not have improved survival over patients with known or suspected tumors. A small number of patients survived for more than 5 years without recurrence. However, this group had no variable in common that would aid in the selection of similar patients in the future. Because of the high rate of recurrent tumor and lack of positive prognostic variables, transplantation should seldom be used as a treatment for cholangiocarcinoma. For transplantation to be a viable treatment in the future, more effective adjuvant therapies are necessary.Keywords
This publication has 22 references indexed in Scilit:
- Aggressive Surgical Treatment of Intrahepatic Cholangiocarcinoma: Predictors of OutcomesJournal of the American College of Surgeons, 1998
- Surgical treatment of 32 patients with peripheral intrahepatic cholangiocarcinomaBritish Journal of Surgery, 1998
- Surgical management of intrahepatic cholangiocarcinoma: A 31-year experienceJournal of Hepato-Biliary-Pancreatic Surgery, 1998
- Is liver transplantation indicated for cholangiocarcinoma?Journal of Hepato-Biliary-Pancreatic Surgery, 1998
- Hepatic Resection and Transplantation for Peripheral CholangiocarcinomaJournal of the American College of Surgeons, 1997
- A Western surgical experience of peripheral cholangiocarcinomaBritish Journal of Surgery, 1996
- Is liver transplantation indicated for cholangiocarcinoma?The American Journal of Surgery, 1993
- The Role of Liver Transplantation in Hepatobiliary Malignancy. A Retrospective Analysis of 95 Patients with Particular Regard to Tumor Stage and RecurrenceAnnals of Surgery, 1989
- Radical resection and liver grafting as the two main components of surgical strategy in the treatment of proximal bile duct cancerWorld Journal of Surgery, 1988
- Orthotopic Liver Transplantation for Primary Sclerosing CholangitisAnnals of Surgery, 1988