Background : Hilar cholangiocarcinoma is known for its poor prognosis due to the late diagnosis. In order for the long term survival, curative resection is necessary. However, after surgical resection, the 5-year survival rates vary depending on various literature from 14~48%. The aim of this study is to evaluate the prognostic factors for long term survival in hilar cholangiocarcinoma.

Methods : From January 2000 to December 2020, patients who underwent curative resection for hilar cholangiocarcinoma were enrolled. Demographics, surgical and oncological outcomes, short term complications, recurrence, pathologic results, and survival were analyzed.

Results : Total 407 patients diagnosed with hilar cholangiocarcinoma who underwent curative resection at Samsung Medical Center from 2000 to 2020 were included in this study. Among them 382 patients (93.86 %) underwent major hepatectomy. Overall major morbidity (greater than Clavien-Dindo Classification grade 2) occurred in 163 patients (40.1%). Perineural invasion (HR 1.68, 1.09 to 2.58) and lymph node involvement (HR 3.55, 2.36 to 5.35) were significant prognostic factors. The median disease-free survival was 26 months and median survival was 32 months. 1-, 3-, and 5-year survival rates were 82.0%, 54.0%, and 32.6% respectively.

Conclusions : With the analysis of only the curative resection of hilar cholangiocarcinoma, without lymph node involvement or the perineural invasion would have favorable prognosis.