KMID : 0870420050090020106
|
|
Korean Journal of Hepato-Biliary-Pancreatic Surgery 2005 Volume.9 No. 2 p.106 ~ p.112
|
|
Actual Long-Term Outcome of Klatskin¢¥s Tumor after Surgical Resction
|
|
Han Sung-Sik
Lee Kuhn-Uk Jang Jin-Young Kim Sun-Whe Park Yong-Hyun Park Yun-Chan
|
|
Abstract
|
|
|
Purpose: To analyze the actual long-term outcomes of Klatskin¡¯s tumors after surgical resection and identify the factors affecting the long-term survival.
Methods: We reviewed the medical records of 145 Klatskin¡¯s tumor cases, who underwent an operation between 1991 and 1999, and analyzed the actual outcomes and prognostic factors. The mean age of the subjects was 55, with a male to female ratio of 2.8:1. Seventy-six patients underwent resection with curative intent (resection rate 52.4%), including hilar resection (n=23), extended right hepatectomy (n=25), extended left hepatectomy (n=26) and hepatopancreatoduodenectomy (n=4). The operative mortality was 2.6%. The resection margin involvement rate was 21%. We also compared the clinicopathological characteristics between the long- term and short-term survivors.
Results : Twenty-one patients survived more than 5 years, with an actual 5-year survival rate of 28%. Among the survivors, 4 had a recurrent disease at 5 years and 3 developed a recurrence after 5 years. Some patients with well-known poor prognostic factors, such as lymph node metastasis and resection margin involvement, survived longer than 5 years. Lymph node metastasis was identified as a significant prognostic factor in a multivariate analysis. The long-term survivors had favorable T and N stages compared with the short-term survivors.
Conclusions: The actual 5-year survival rate was 28%. Lymph node metastasis was found to be a significant prognostic factor. Long-term follow up is mandatory, as recurrences occurred later than 5 years after surgery. Aggressive surgical resection should be attempted to gain a chance for survival, even in patients with poor prognostic factors.
|
|
KEYWORD
|
|
Klatskin¢¥s Tumor, Survival Rate, Prognosis
|
|
FullTexts / Linksout information
|
|
|
|
Listed journal information
|
|
|
|