Peri-hilar cholangiocarcinoma: results from the UK nationwide CAPBIL study.

McClements, J.; Koh, A.; Sellappan, H.; Blackburn, L.; Brooks, A.; Clements, J.; Merali, N.; Frampton, A.; Gulbahar, S.; Davidson, B.; Almomani, E.; Bartlett, D.; Papadopoulos, G.; Karavias, D.; Rowcroft, A.; Lucocq, J.; Harrison, EM.; Morrison-Jones, V.; Welsh, F.; Pathanki, A.; Marangoni, G.; Bruno, P.; Skipworth, J.; Spiers, H.; Kosmoliaptsis, V.; Gilbert, T.; Malik, H.; Vijayashanker, A.; Menon, K.; Patel, W.; Bekheit, M.; Tanno, L.; Silva, M.; Brown, C.; Kumar, N.; Triance, J.; Shah, N.; Alsaoudi, T.; Bhardwaj, N.; Nassar, H.; Mownah, O.; Yeung, D.; Bhogal, R.; Blanco-Colino, R.; Farid, S.; Aljaberi, R.; Pandanaboyana, S.; Abdelmohsin, O.; Aroori, S.; Evans, D.; Athwal, T.; Lodge, P.; Gomez, D.

Peri-hilar cholangiocarcinoma: results from the UK nationwide CAPBIL study.

All Authors

McClements, J.

Koh, A.

Sellappan, H.

Blackburn, L.

Brooks, A.

Clements, J.

Merali, N.

Frampton, A.

Gulbahar, S.

Davidson, B.

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LTHT Author

Farid, Shahid
Lodge, Peter

LTHT Department

Abdominal Medicine & Surgery
Transplant & Hepatobiliary Surgery
Hepatobiliary Surgery

Publication Date

2025

Item Type

Journal Article
Multicenter Study

Abstract

BACKGROUND: The role of liver transplantation as a treatment option for de novo resectable peri-hilar cholangiocarcinoma (pCCA) is controversial. This study investigated the outcomes following resection of early-stage pCCA in the UK. METHODS: Patients undergoing resection for pCCA between 2014 and 2022 across 22 UK centres were included. Early-stage pCCA was defined as tumour size<3cm with no nodal disease (N0) on histopathology analysis. Clinical and survival data were collated. RESULTS: Of the 450 patients included, 138 patients underwent resection for early-stage pCCA. In the early-stage pCCA group, CD >= IIIa morbidity was 39.1 % (n = 54) and 90-day mortality was 10.1 % (n = 14). Sixty-four (46.4 %) patients received adjuvant chemotherapy, but this was reduced in those with CD >= IIIa morbidity (n = 17, 31.5 %). Early-stage tumours had a significantly lower vascular invasion (n = 57, 41.3 %) and R1 margin (n = 46, 33.3 %) compared to later-stage pCCA [62.2 % (n = 194) and 54.2 % (n = 169) respectively, p < 0.001). The median disease-free and overall survival was significantly better in patients with early-stage pCCA compared to more advanced tumours (p < 0.001). Male gender (p = 0.039) and Post-Hepatectomy Liver Failure (PHLF, p = 0.010) were associated with significantly worse disease-free survival, while biliary drainage (p = 0.013), PHLF (p < 0.001) and vascular invasion (p = 0.030) were associated with significantly poorer overall survival. CONCLUSION: Resection of early-stage pCCA tumours is associated with good clinical and survival outcomes in centralised HPB centres.