TY - JOUR
T1 - A comparison of treatment and outcomes of perihilar cholangiocarcinoma between Eastern and Western centers
AU - Olthof, Pim B.
AU - Miyasaka, Mamoru
AU - Koerkamp, Bas Groot
AU - Wiggers, Jimme K.
AU - Jarnagin, William R.
AU - Noji, Takehiro
AU - Hirano, Satoshi
AU - van Gulik, Thomas M.
PY - 2019
Y1 - 2019
N2 - Background: Perihilar cholangiocarcinoma (PHC) often requires extensive surgery which is associated with substantial morbidity and mortality. This study aimed to compare an Eastern and Western PHC cohort in terms of patient characteristics, treatment strategies and outcomes including a propensity score matched analysis. Methods: All consecutive patients who underwent combined biliary and liver resection for PHC between 2005 and 2016 at two Western and one Eastern center were included. The overall perioperative and long-term outcomes of the cohorts were compared and a propensity score matched analysis was performed to compare perioperative outcomes. Results: A total of 210 Western patients were compared to 164 Eastern patients. Western patients had inferior survival compared to the East (hazard-ratio 1.72 (1-23-2.40) P < 0.001) corrected for age, ASA score, tumor stage and margin status. After propensity score matching, liver failure rate, morbidity, and mortality were similar. There was more biliary leakage (38% versus 13%, p = 0.015) in the West. Conclusion: There were major differences in patient characteristics, treatment strategies, perioperative outcomes and survival between Eastern and Western PHC cohorts. Future studies should focus whether these findings are due to the differences in the treatment or the disease itself.
AB - Background: Perihilar cholangiocarcinoma (PHC) often requires extensive surgery which is associated with substantial morbidity and mortality. This study aimed to compare an Eastern and Western PHC cohort in terms of patient characteristics, treatment strategies and outcomes including a propensity score matched analysis. Methods: All consecutive patients who underwent combined biliary and liver resection for PHC between 2005 and 2016 at two Western and one Eastern center were included. The overall perioperative and long-term outcomes of the cohorts were compared and a propensity score matched analysis was performed to compare perioperative outcomes. Results: A total of 210 Western patients were compared to 164 Eastern patients. Western patients had inferior survival compared to the East (hazard-ratio 1.72 (1-23-2.40) P < 0.001) corrected for age, ASA score, tumor stage and margin status. After propensity score matching, liver failure rate, morbidity, and mortality were similar. There was more biliary leakage (38% versus 13%, p = 0.015) in the West. Conclusion: There were major differences in patient characteristics, treatment strategies, perioperative outcomes and survival between Eastern and Western PHC cohorts. Future studies should focus whether these findings are due to the differences in the treatment or the disease itself.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85050948289&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/30087051
U2 - https://doi.org/10.1016/j.hpb.2018.07.014
DO - https://doi.org/10.1016/j.hpb.2018.07.014
M3 - Article
C2 - 30087051
SN - 1365-182X
VL - 21
SP - 345
EP - 351
JO - HPB: The official journal of the International Hepato Pancreato Biliary Association
JF - HPB: The official journal of the International Hepato Pancreato Biliary Association
IS - 3
ER -