Peri-hilar cholangiocarcinoma: results from the UK nationwide CAPBIL study.
McClements, Jane Koh, Amanda Sellappan, Harivinthan Blackburn, Lauren Brooks, Adam Clements, Jake Merali, Nabeel Frampton, Adam Gulbahar, Syeda Davidson, Brian
McClements, Jane
Koh, Amanda
Sellappan, Harivinthan
Blackburn, Lauren
Brooks, Adam
Clements, Jake
Merali, Nabeel
Frampton, Adam
Gulbahar, Syeda
Davidson, Brian
Abstract
Background: The role of liver transplantation as a treatment option for de novo resectable peri-hilar cholangiocarcinoma (pCCA) is controversial. This study investigated the outcomes following resection of early-stage pCCA in the UK.
Methods: Patients undergoing resection for pCCA between 2014 and 2022 across 22 UK centres were included. Early-stage pCCA was defined as tumour size<3cm with no nodal disease (N0) on histopathology analysis. Clinical and survival data were collated.
Results: Of the 450 patients included, 138 patients underwent resection for early-stage pCCA. In the early-stage pCCA group, CD ≥ IIIa morbidity was 39.1 % (n = 54) and 90-day mortality was 10.1 % (n = 14). Sixty-four (46.4 %) patients received adjuvant chemotherapy, but this was reduced in those with CD ≥ IIIa morbidity (n = 17, 31.5 %). Early-stage tumours had a significantly lower vascular invasion (n = 57, 41.3 %) and R1 margin (n = 46, 33.3 %) compared to later-stage pCCA [62.2 % (n = 194) and 54.2 % (n = 169) respectively, p < 0.001). The median disease-free and overall survival was significantly better in patients with early-stage pCCA compared to more advanced tumours (p < 0.001). Male gender (p = 0.039) and Post-Hepatectomy Liver Failure (PHLF, p = 0.010) were associated with significantly worse disease-free survival, while biliary drainage (p = 0.013), PHLF (p < 0.001) and vascular invasion (p = 0.030) were associated with significantly poorer overall survival.
Conclusion: Resection of early-stage pCCA tumours is associated with good clinical and survival outcomes in centralised HPB centres.
MIDER Authors
Date
2025-08-22
Type
Article
Subject
Liver transplantation, Bile duct neoplasms
Collections
Citation
McClements J, Koh A, Sellappan H, Blackburn L, Brooks A, Clements J, Merali N, Frampton A, Gulbahar S, Davidson B, Almomani E, Bartlett D, Papadopoulos G, Karavias D, Rowcroft A, Lucocq J, Harrison EM, Morrison-Jones V, Welsh F, Pathanki A, Marangoni G, Bruno P, Skipworth J, Spiers H, Kosmoliaptsis V, Gilbert T, Malik H, Vijayashanker A, Menon K, Patel W, Bekheit M, Tanno L, Silva M, Brown C, Kumar N, Triance J, Shah N, Alsaoudi T, Bhardwaj N, Nassar H, Mownah O, Yeung D, Bhogal R, Blanco-Colino R, Farid S, Aljaberi R, Pandanaboyana S, Abdelmohsin O, Aroori S, Evans D, Athwal T, Lodge P, Gomez D; UK HPB Research Collaborative Group, United Kingdom. Peri-hilar cholangiocarcinoma: results from the UK nationwide CAPBIL study. HPB (Oxford). 2025 Nov;27(11):1367-1378. doi: 10.1016/j.hpb.2025.08.003. Epub 2025 Aug 22.
Journal / Source Title
HPB
DOI
10.1016/j.hpb.2025.08.003
PMID
40921691
Publisher
Elsevier
Publisher’s URL
https://www.sciencedirect.com/journal/hpb
https://onlinelibrary.wiley.com/journal/14772574
https://onlinelibrary.wiley.com/journal/14772574