Improved outcome of resection of XXXX ( @entity6984 ).

@entity1 @entity5 @entity201 @entity3 @entity6984
BACKGROUND: Treatment of @entity201 ( @entity6984 ) has changed in many aspects. A more extensive surgical approach, as proposed by Japanese surgeons, has been applied in our center over the last 5 years; it combines hilar resection with partial hepatectomy for most @entity5 . The aim of this study was to assess the outcome of a 15-year evolution in the surgical treatment of @entity6984 . METHODS: A total of 99 consecutive @entity1 underwent resection for @entity201 in three 5-year time periods: periods 1 (1988-1993; n=45), 2 (1993-1998; n=25), and 3 (1998-2003; n=29). Outcome was evaluated by assessment of completeness of resection, postoperative morbidity and mortality, and survival. RESULTS: The proportion of margin negative resections increased significantly from 13% in period 1 to 59% in period 3 (P<.05). Two-year survival increased significantly from 33%+/-7% and 39%+/-10% in periods 1 and 2 to 60%+/-11% in period 3 (P<.05). Postoperative morbidity and mortality were considerable but did not increase with this changed surgical strategy (68% and 10%, respectively, in period 3). Lymph node @entity3 was, next to period of resection, also associated with survival in univariate analysis. CONCLUSIONS: Mainly in the last 5-year period (1998-2003), when the Japanese surgical approach was followed, more hilar resections were combined with partial liver resections that included segments 1 and 4, thus leading to more R0 resections. This, together with a decrease in lymph node @entity3 , resulted in improved survival without significantly affecting postoperative morbidity or mortality.
