Background/aims: To analyze the actual long-term outcome of Klatskin's tumor after surgical resection and to identify the factors affecting long-term survival.
Methodology: We reviewed the records of 145 Klatskin's tumor cases who underwent operation from 1991 to 1999 and analyzed the actual outcome and prognostic factors. We also compared the clinicopathologic characteristics of long-term and short-term survivors.
Results: Seventy-six patients underwent resection (resection rate 52.4%). Twenty-one of the 76 patients survived more than 5 years, an actual 5-year survival rate of 28%, and of these survivors, 4 had recurrent disease at 5 years and 3 developed recurrence after 5 years. Five patients with well-known poor prognostic factors, such as, lymph node metastasis and resection margin involvement survived more than 5 years. Lymph node metastasis was identified as a significant prognostic factor, and long-term survivors were found to have more favorable T and N stages than short-term survivors.
Conclusions: The actual 5-year survival rate after resection was 28%, and lymph node metastasis was identified as a significant prognostic factor. Long-term follow-up is mandatory, because recurrence occurs beyond 5 years after surgery. An aggressive surgical approach should be used to give patients with poor prognostic factors a chance of survival.