Abstract
Introduction: Hilar cholangiocarcinomas (HCCA) are tumours involving the biliary confluence. At present, radical surgery offers the only chance of long term survival. However this may be challenging given the complexity of hilar anatomy. Blumgart and Jarnagin described a pre-operative staging system incorporating the effect of local tumour extent and its impact on adjacent structures and has been demonstrated to correlate better with actual surgical resectability. The primary aim of this study is to describe the correlation between pre-operative Blumgart-Jarnagin staging and its correlation with surgical resectability. Methods: Patients who underwent surgical resection for hilar cholangiocarcinoma at the Singapore General Hospital (SGH) between 1st January 2002 to 1st January 2013 were identified from a prospectively maintained institutional database. All patients were staged based on the criteria described by Blumgart and Jarnagin. Correlation with surgical resectability was then determined. Results: A total of 19 patients were identified. Overall resectability was 57.8% (n=11). Patients with Blumgart-Janargin stage T1 had the highest rates of resectability at 80%. Patients with stage T2 and T3 disease had resectability rates of 25% and 40% respectively. Median overall survival was 13.6 months. Table 1 shows the Blumgbart-Janargin stage and the corresponding patient outcomes. Conclusion: The Blumgart-Jarnagin staging system is useful in predicting tumour resectability for HCCA.Tabled 1Table 1T1T2T3TotalNumber104519Resectability (n, %)8 (80)1 (25)2 (40)11 (57.8)R0 resection (n, %)7 (70)1 (25)1 (20)9 (47.4)Hepatic resection (n, %)6 (60)1 (25)2 (40)9 (47.4)Metastasis (n, %)0 (0)1 (25)2 (40)3 (15.8)Median survival (months)18.311.55.613.6 Open table in a new tab
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