02818nas a2200349   4500008003900000245007400039210006900113260001000182300001300192490000700205520180400212653003002016653002702046653001002073653000902083653003502092653004602127653001102173653001102184653001402195653000902209653001602218653004602234653001402280653004502294653002202339653002202361100001502383700001202398700001302410856004502423       2000                          d00aLiver transplantation for cholangiocarcinoma: results in 207 patients0 aLiver transplantation for cholangiocarcinoma results in 207 pati  c46478  a1633 - 70 v693 aBACKGROUND: Because of the high incidence of recurrent tumor, many surgeons have become disenchanted with transplantation as a treatment for cholangiocarcinoma. METHODS: The Cincinnati Transplant Tumor Registry database was used to examine 207 patients who underwent liver transplantation for otherwise unresectable cholangiocarcinoma or cholangiohepatoma. Specific factors evaluated included tumor size, presence of multiple nodules, evidence of tumor spread at surgery, and treatment with adjuvant chemotherapy and/or radiation therapy. Incidentally found tumors were compared to tumors that were known or suspected to be present before transplantation. RESULTS: The 1, 2, and 5-year survival estimates using life table analysis were 72, 48, and 23%. Fifty-one percent of patients had recurrence of their tumors after transplantation and 84% of recurrences occurred within 2 years of transplantation. Survival after recurrence was rarely more than 1 year. Forty-seven percent of recurrences occurred in the allograft and 30% in the lungs. Tumor recurrence, and evidence of tumor spread at the time of surgery, were negative prognostic variables. There were no positive prognostic variables. Patients with incidentally found cholangiocarcinomas did not have improved survival over patients with known or suspected tumors. A small number of patients survived for more than 5 years without recurrence. However, this group had no variable in common that would aid in the selection of similar patients in the future. CONCLUSIONS: Because of the high rate of recurrent tumor and lack of positive prognostic variables, transplantation should seldom be used as a treatment for cholangiocarcinoma. For transplantation to be a viable treatment in the future, more effective adjuvant therapies are necessary.10a*Bile Ducts, Intrahepatic10a*Liver Transplantation10aAdult10aAged10aBile Duct Neoplasms / *surgery10aCholangiocarcinoma / secondary / *surgery10aFemale10aHumans10aIncidence10aMale10aMiddle Aged10aNeoplasm Recurrence, Local / epidemiology10aPrognosis10aResearch Support, U.S. Gov't, Non-P.H.S.10aSurvival Analysis10aTreatment Outcome1 aMeyer, C G1 aPenn, I1 aJames, L  uhttps://notifylibrary.org/reference/1010