Results of resection for hilar cholangiocarcinoma with analysis of prognostic factors.

Resection for hilar cholangiocarcinoma remains a challenging procedure and recent published results continue to show that few patients are cured of their disease. The objective of this review was to determine the results of radical resection and to identify factors associated with long-term survival. Retrospective review of resection for hilar cholangiocarcinoma in 29 consecutive patients with statistical analysis of prognostic factors, including p53 status. The mortality and morbidity rates were 6.9% and 34%, respectively. The overall 5-year survival was 20% with the median survival being 16 months. Univariate analysis identified the following factors associated with poor survival; involved lymph nodes, vascular invasion, advanced tumor stage, positive tumor margins, and p53 mutation. However, none of these factors was associated with poor survival by multivariate analyses. Radical resection for hilar cholangiocarcinoma can be performed with acceptable morbidity and mortality, but most patients succumb to their disease. p53 status may be a helpful adjunct to routine pathological staging.