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Copyright ©2013 Baishideng Publishing Group Co.
World J Gastrointest Oncol. Jul 15, 2013; 5(7): 147-158
Published online Jul 15, 2013. doi: 10.4251/wjgo.v5.i7.147
Table 1 Staging of perihilar cholangiocarcinoma (Green FL 2002)
Tumor, nodes and metastases definitions
Primary tumor
Tis Carcinoma in situ
T1 Tumor confined to the bile duct histologically
T2 Tumor invades beyond the wall of the bile duct
T3 Tumor invades the liver, gallbladder, pancreas, and/or ipsilateral branches of the portal vein or hepatic artery
T4 Tumor invades any of the following: main portal vein or its branches bilaterally, common hepatic artery, or other adjacent structures, such as the colon, stomach, duodenum, or abdominal wall.
Regional lymph nodes
N0 No regional lymph node metastasis
N1 Regional lymph node metastases
M0 No distant metastasis
M1 Distant metastasis
Stage grouping
Stage 0 Tis, N0, M0
Stage IA T1, N0, M0
Stage IB T2, N0, M0
Stage IIA T3, N0, M0
Stage IIB T1, N1, M0 T2, N1, M0 T3, N1, M0
Stage III T4, any N, M0
Stage IV Any T, any N, M1
Table 2 Memorial Sloan Kettering Cancer Centre stage
StageHilar involvementPortal veinLobar atrophy
T1Biliary confluence ± 1/2 unilateral extension to second-order biliary radiclesNoNo
T2Biliary confluence ± unilateral extension to second-order biliary radicles+ Ipsilateral+ Ipsilateral
Biliary confluence + bilateral extension to second-order biliary radiclesYes/NoYes/No
Biliary confluence + unilateral extension to second-order biliary radicles+ ContralateralYes/No
T3Biliary confluence + unilateral extension to second-order biliary radicles with contralateral hepatic lobar atrophy;Yes/No+ Contralateral
Biliary confluence + unilateral/bilateralBilateralYes/No
Table 3 Prognostic factors and 5-year survival rate
Hilar cholangiocarcinomaNo. of patientsPrognostic factorsOperative mortality(%)5-yr SV (%)
Jarnagin et al[14]80Margin, hepatectomy, differentiation1027
Seyama et al[20]58Lymph nodes040
Dinant et al[27]99Margin, resection period, lymph nodes1527
DeOliveira et al[43]281Margin, lymph nodes510
Rea et al[45]46Lymph nodes, tumor grade, bilirubin926
Silva et al[46]45Tumor stage, margin911
Witzigmann et al[47]60Residual tumor status, grading822
Baton et al[48]59Chemotherapy, margin, lymph nodes520
Wahab et al[55]243Margin, S1 resection, lymph nodes, grading716
de Jong et al[90]305Lymph nodes, margin520
Table 4 Morbidity and mortality rate and R0 resections
Ref.ResectionsR0(%)MorbidityMortality5-yr Survival rate
Burke et al[3]3083NA645
Nakeeb et al[4]1092647411
Jarnagin et al[14]8078641026
Nimura et al[15]558441641
Jarnagin et al[17]10677628NA
Seyama et al[20]876443040
Kosuge et al[23]655237933
Neuhaus et al[24]806155822
Launois et al[25]131NANA19NA
Kondo et al[26]4095480NA
Dinant et al[27]9931661527
Gerhards et al[29]112146518NA
Hemming et al[32]538040935
IJitsma et al[33]4265761219
Kawarada et al[34]6564282.326
Klempnauer et al[35]15177NA1028
Miyazaki et al[37]7671331326
Nimura et al[38]1426149926
Su et al[39]4949471015
Todoroki et al[41]1011414428
DeOliveira et al[43]2816260530
Nagino et al[44]57476.543.14.732.5
Rea et al[45]468052926
Nuzzo et al[74]44077.347.58.625.5
Ito et al[85]386332033
Kawasaki et al7968141.322