Hilar cholangiocarcinoma: Tumor depth as a predictor of outcome

Mechteld C. De Jong, Seung Mo Hong, Mathew M. Augustine, Michael G. Goggins, Christopher L. Wolfgang, Kenzo Hirose, Richard D. Schulick, Michael A. Choti, Robert A. Anders, Timothy M. Pawlik

Research output: Contribution to journalArticlepeer-review

34 Scopus citations


Background: The American Joint Committee on Cancer staging system for hilar cholangiocarcinoma may be inaccurate because the bile duct lacks discrete tissue boundaries. Objectives: To examine the accuracy of the American Joint Committee on Cancer staging schemes and to determine the prognostic implications of tumor depth. Design, Setting, and Patients: From January 1, 1987, through December 31, 2009, there were 106 patients who underwent resection of hilar cholangiocarcinoma who had pathologic slides available for re-review. Main Outcome Measures: Tumor depth and overall survival. Results: Overall median survival was 19.9 months. The 6th and 7th editions of the T-classification criteria were unable to discriminate among T1, T2, and T3 lesions (P>.05 for all). Median survival was associated with the invasion depth of the tumor (≥5 mm vs <5 mm): 18 months vs 30 months (P=.01). On multivariate analysis, tumor depth remained predictive of disease-specific death (hazard ratio,1.70; P=.03). Conclusions: The American Joint Committee on Cancer T-classification criteria did not stratify patients with regard to prognosis. Depth of tumor invasion is a better predictor of long-term outcome.

Original languageEnglish (US)
Pages (from-to)697-703
Number of pages7
JournalArchives of surgery
Issue number6
StatePublished - Jun 2011

ASJC Scopus subject areas

  • Surgery


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