Liver transplantation for peripheral cholangiocarcinoma: Spanish experience

• Published in: Transplantation proceedings Vol. 35; no. 5; pp. 1823 - 1824
• Main Authors: Robles, R, Figueras, J, Turrión, V.S, Margarit, C, Moya, A, Varo, E, Calleja, J, Valdivieso, A, Garcia-Valdelcasas, J.C, López, P, Gómez, M, de Vicente, E, Loinaz, C, Santoyo, J, Fleiras, M, Bernardos, A, Marín, C, Fernández, J.A, Jaurrieta, E, Parrilla, P
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York, NY Elsevier Inc 01-08-2003; Elsevier Science
• Subjects: Bile Duct Neoplasms - mortality; Bile Duct Neoplasms - pathology; Bile Duct Neoplasms - surgery; Bile Ducts, Intrahepatic; Biological and medical sciences; Cholangiocarcinoma - mortality; Cholangiocarcinoma - pathology; Cholangiocarcinoma - surgery; Follow-Up Studies; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Liver Transplantation; Liver, biliary tract, pancreas, portal circulation, spleen; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Medical sciences; Neoplasm Metastasis; Palliative Care; Recurrence; Retrospective Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Survival Analysis; Time Factors; Tumors; Europe; Spain; Human; Digestive system; Hepatic disease; Transplantation; Malignant tumor; Biliary tract disease; Homotransplantation; Experience; Treatment; Malignant cholangioma; Surgery; Digestive diseases; Graft
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/S0041-1345(03)00725-5

Palliative treatment for nondisseminated unresectable peripheral cholangiocarcinoma (PCC) carries a 0% 5-year survival rate. The role of orthotopic liver transplantation (OLT) in these patients is controversial because the survival rate is lower than with other indications for transplantation and the lack of available donor organs. The aim of this paper was to review the Spanish experience in OLT for PCC to identify prognostic factors for survival.
We retrospectively reviewed 23 patients undergoing OLT in Spain for PCC over a period of 13 years.
The actuarial survival rates were 77%, 65%, and 42% at 1, 3, and 5 years, respectively. The main cause of death was tumor recurrence (35%). Prognotic factors for an adverse outcome were pTNM classification (
P < .05) in the univariate analysis and perineural invasion (
P < .05) and stages III or IVA (
P < .05) in the multivariate analysis.
OLT for nondisseminated irresectable PCC displays higher survival rates at 3 and 5 years than palliative treatments, especially for tumors in the initial stages, which means that more information is needed to help better select PCC patients for transplantation.