Table 1.
Clinical characteristics at time of presentation and at time of transplantation of patients with perihilar cholangiocarcinoma treated with neoadjuvant therapy in anticipation for liver transplantation. Results are shown for the total population first, and are subsequently compared between center 1 and centers 2–12. Results are expressed in N (%) or median (range).
| Characteristics at presentation | Total population (N=287) |
Center 1 (N=193) |
Centers 2–12 (N=94) |
|---|---|---|---|
| Age | 51 (17–70) | 51 (22–70) | 49 (17–69) |
| Gender (male) | 207 (72%) | 138 (72%) | 69 (73%) |
| Underlying Primary Sclerosing Cholangitis | 181 (63%) | 122 (63%) | 59 (63%) |
| Type of cholangiocarcinoma | |||
| - perihilar | 255 (89%) | 177 (92%) | 78 (83%) |
| - combined perihilar + IH | 13 (5%) | 6 (3%) | 7 (7%) |
| - combined perihilar + distal | 19 (7%) | 10 (5%) | 9 (10%) |
| Mass on cross-sectional imaging | 158 (55%) | 109 (56%) | 49 (52%) |
| Mass size (cm) | 2.7 (0.6–6.2) | 2.5 (0.6–5.0) | 2.9 (1.0–6.2) |
| Mass size | |||
| 0–3 cm | 119 (75%) | 84 (77%) | 35 (71%) |
| > 3 cm | 39 (25%) | 25 (23%) | 14 (29%) |
| Intraluminal brushing result | |||
| - positive | 96 (33%) | 64 (33%) | 32 (34%) |
| - suspicious | 57 (20%) | 37 (19%) | 20 (21%) |
| - negative | 110 (38%) | 78 (40%) | 32 (34%) |
| - could not be obtained | 24 (8%) | 14 (7%) | 10 (11%) |
| Intraluminal biopsy result * | |||
| - positive | 65 (23%) | 49 (25%) | 16 (17%) |
| - suspicious | 24 (8%) | 19 (10%) | 5 (5%) |
| - negative | 85 (30%) | 70 (36%) | 15 (16%) |
| - could not be obtained | 113 (39%) | 55 (28%) | 58 (62%) |
| Tissue diagnosis of malignancy from either brushing or biopsy | |||
| - positive / suspicious | 200 (70%) | 138 (73%) | 62 (72%) |
| - negative | 75 (26%) | 51 (26%) | 24 (26%) |
| - could not be obtained | 12 (4%) | 4 (2%) | 8 (9%) |
| FISH result * | |||
| - polysomy | 70 (24%) | 52 (27%) | 18 (19%) |
| - trisomy / negative | 74 (26%) | 60 (31%) | 14 (15%) |
| - not obtained | 143 (50%) | 81 (42%) | 62 (66%) |
| CA 19-9 (U/ml) | 76 (0–28750) | 79 (0–28750) | 73 (0–25856) |
| CA 19-9 > 100 U/ml | 126 (45%) | 89 (47%) | 37 (42%) |
| Bilirubin (mg/dl) | 2.2 (0.2–33.6) | 2.4 (0.3–33.6) | 1.9 (0.2–29.2) |
| INR * | 1.0 (0.8–5.6) | 1.0 (0.8–5.6) | 1.1 (0.8–1.9) |
| Creatinine (mg/dl) * | 0.9 (0.5–2.6) | 0.9 (0.5–2.6) | 0.8 (0.5–2.6) |
| Platelet count (x10E9/l) | 284 (47–897) | 282 (56–867) | 296 (47–662) |
| MELD (calculated) | 10 (6–34) | 10 (6–34) | 10 (6–27) |
| Tumor grade * | |||
| - well differentiated (G1) | 4 (1%) | 1 (1%) | 3 (3%) |
| - moderately differentiated (G2) | 20 (7%) | 16 (8%) | 4 (4%) |
| - poorly differentiated (G3) | 34 (12%) | 26 (13%) | 8 (9%) |
| - undifferentiated (G4) | 5 (2%) | 4 (2%) | 1 (1%) |
| - low-grade dysplasia | 3 (1%) | 1 (1%) | 2 (2%) |
| - high-grade dysplasia | 18 (6%) | 13 (7%) | 5 (5%) |
| - no tissue available or grade unobtainable | 203 (71%) | 132 (68%) | 71 (72%) |
| Characteristics at Liver Transplantation |
Total population (N=214) |
Center 1 (N=131) |
Centers 2–12 (N=83) |
| CA 19-9 (U/ml) | 48 (0–3300) | 55 (0–2370) | 35 (0–3300) |
| MELD (calculated) | 10 (6–40) | 11 (6–40) | 9 (6–26) |
| Type of allograft | |||
| - deceased donor | 152 (71%) | 88 (67%) | 64 (77%) |
| - living donor | 52 (29%) | 43 (33%) | 19 (23%) |
| Quality of allograft | |||
| - standard criteria donor | 173 (81%) | 106 (81%) | 67 (81%) |
| - extended criteria donor | 41 (19%) | 25 (19%) | 16 (19%) |
| Additional pancreaticoduodenectomy for distal bile duct involvement | 22 (10%) | 12 (9%) | 10 (12%) |
| Residual tumor tissue in explant * | 112 (52%) | 61 (47%) | 51 (61%) |
| Final tumor grade in explant * | |||
| - well differentiated (G1) | 10 (5%) | 1 (8%) | 9 (11%) |
| - moderately differentiated (G2) | 42 (20%) | 22 (17%) | 20 (24%) |
| - poorly differentiated (G3) | 40 (19%) | 29 (22%) | 11 (13%) |
| - undifferentiated (G4) | 5 (2%) | 4 (3%) | 1 (1%) |
| - no tumor tissue seen or grade not obtainable due to complete radiation-induced necrosis | 117 (54%) | 75 (57%) | 42 (51%) |
Comparison is based on Chi-square tests for categorical and Mann-Whitney-U tests for continuous variables.
*
P<.05.