ArticleThe British journal of surgery2023
Multivariable prediction model for both 90-day mortality and long-term survival for individual patients with perihilar cholangiocarcinoma: does the predicted survival justify the surgical risk?
Article in The British journal of surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
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27 citing papers in PubMed, 38 citations in OpenAlex.
- Editorial Comment: Borderline Resectability in Perihilar Cholangiocarcinoma-as Simple as ABC or 1-2-3?Annals of surgical oncology · 2026Article
- Perioperative approaches for patients with biliary tract cancer.Nature reviews. Clinical oncology · 2026Review
- Preoperative biliary drainage in perihilar cholangiocarcinoma: retrospective multicentre analysis.BJS open · 2026Observational
- Liver resection with and without vascular resection versus transplantation for de novo perihilar cholangiocarcinoma.Hepatology (Baltimore, Md.) · 2026Article
- Value of albumin-bilirubin grade for 90-day mortality and long-term outcomes in patients with perihilar cholangiocarcinoma: a multicenter retrospective cohort study.Therapeutic advances in medical oncology · 2026Article
- Cholangiocarcinoma 2026: status quo, unmet needs and priorities.Nature reviews. Gastroenterology & hepatology · 2026Review
- ASO Author Reflections: Vascular Resection in Perihilar Cholangiocarcinoma Surgery.Annals of surgical oncology · 2025Article
- Endoscopic Ultrasound for Nodal Staging in Patients with Resectable Cholangiocarcinoma.Journal of clinical medicine · 2025Article
- Improved Outcomes Following Resection of Perihilar Cholangiocarcinoma: A 27-Year Experience.Annals of surgical oncology · 2025Article
- Safety and efficacy of combined portal and hepatic vein embolisation in patients with colorectal liver metastases (DRAGON1): a multicentre, single-arm clinical trial.The Lancet regional health. Europe · 2025Article
- Article
- Predictive model for very early recurrence of patients with perihilar cholangiocarcinoma: a machine learning approach.Hepatobiliary surgery and nutrition · 2025Article
- Preoperative factors predicting outcomes in patients with suspected perihilar cholangiocarcinoma referred for curative resection- a single-center 10-year experience.Langenbeck's archives of surgery · 2024Article
- AI-based digital histopathology for perihilar cholangiocarcinoma: A step, not a jump.Journal of pathology informatics · 2024Article
- Article
- Comparing Survival of Perihilar Cholangiocarcinoma After R1 Resection Versus Palliative Chemotherapy for Unresected Localized Disease.Annals of surgical oncology · 2024Article
- ASO Author Reflections: Palliative Therapy Might be an Alternative When the Risks of Surgery for Perihilar Cholangiocarcinoma are High.Annals of surgical oncology · 2024Article
- Risk model for morbidity and mortality following liver surgery based on a national Japanese database.Annals of gastroenterological surgery · 2024Article
- Major Hepatectomy for Perihilar Cholangiocarcinoma: Taking Sides.Annals of surgical oncology · 2024Article
- Interpretation of mebrofenin and etifenin hepatobiliary scintigraphy before major liver resection.Langenbeck's archives of surgery · 2024Article
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15 authors at 11 institutions in 5 countries.
Funding
Abstract
backgroundThe risk of death after surgery for perihilar cholangiocarcinoma is high; nearly one in every five patients dies within 90 days after surgery. When the oncological benefit is limited, a high-risk resection may not be justified. This retrospective cohort study aimed to create two preoperative prognostic models to predict 90-day mortality and overall survival (OS) after major liver resection for perihilar cholangiocarcinoma.
methodsSeparate models were built with factors known before surgery using multivariable regression analysis for 90-day mortality and OS. Patients were categorized in three groups: favourable profile for surgical resection (90-day mortality rate below 10 per cent and predicted OS more than 3 years), unfavourable profile (90-day mortality rate above 25 per cent and/or predicted OS below 1.5 years), and an intermediate group.
resultsA total of 1673 patients were included. Independent risk factors for both 90-day mortality and OS included ASA grade III-IV, large tumour diameter, and right-sided hepatectomy. Additional risk factors for 90-day mortality were advanced age and preoperative cholangitis; those for long-term OS were high BMI, preoperative jaundice, Bismuth IV, and hepatic artery involvement. In total, 294 patients (17.6 per cent) had a favourable risk profile for surgery (90-day mortality rate 5.8 per cent and median OS 42 months), 271 patients (16.2 per cent) an unfavourable risk profile (90-day mortality rate 26.8 per cent and median OS 16 months), and 1108 patients (66.2 per cent) an intermediate risk profile (90-day mortality rate 12.5 per cent and median OS 27 months).
conclusionPreoperative risk models for 90-day mortality and OS can help identify patients with resectable perihilar cholangiocarcinoma who are unlikely to benefit from surgical resection. Tailored shared decision-making is particularly essential for the large intermediate group.
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