• Gregory V Schimizzi, Linda X Jin, Jesse T Davidson, Bradley A Krasnick, Cecilia G Ethun, Timothy M Pawlik, George Poultsides, Thuy Tran, Kamran Idrees, Chelsea A Isom, Sharon M Weber, Ahmed Salem, William G Hawkins, Steven M Strasberg, Maria B Doyle, William C Chapman, Martin Robert C G RCG Division of Surgical Oncology, Department of Surgery, University of Louisville, Louisville, KY, United States., Charles Scoggins, Perry Shen, Harveshp D Mogal, Carl Schmidt, Eliza Beal, Ioannis Hatzaras, Rivfka Shenoy, Shishir K Maithel, and Ryan C Fields.
• Department of Surgery and the Alvin J. Siteman Cancer Center, Washington University School of Medicine, St Louis, MO, United States.
• HPB (Oxford). 2018 Apr 1; 20 (4): 332-339.

BackgroundSurgical resection is the cornerstone of curative-intent therapy for patients with hilar cholangiocarcinoma (HC). The role of vascular resection (VR) in the treatment of HC in western centres is not well defined.MethodsUtilizing data from the U.S. Extrahepatic Biliary Malignancy Consortium, patients were grouped into those who underwent resection for HC based on VR status: no VR, portal vein resection (PVR), or hepatic artery resection (HAR). Perioperative and long-term survival outcomes were analyzed.ResultsBetween 1998 and 2015, 201 patients underwent resection for HC, of which 31 (15%) underwent VR: 19 patients (9%) underwent PVR alone and 12 patients (6%) underwent HAR either with (n = 2) or without PVR (n = 10). Patients selected for VR tended to be younger with higher stage disease. Rates of postoperative complications and 30-day mortality were similar when stratified by vascular resection status. On multivariate analysis, receipt of PVR or HAR did not significantly affect OS or RFS.ConclusionIn a modern, multi-institutional cohort of patients undergoing curative-intent resection for HC, VR appears to be a safe procedure in a highly selected subset, although long-term survival outcomes appear equivalent. VR should be considered only in select patients based on tumor and patient characteristics.Copyright © 2017 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.

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