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
Affiliation
Belfast Health and Social Care Trust; Nottingham University Hospitals NHS Trust; Royal Surrey NHS Foundation Trust; Royal Free London NHS Foundation Trust; University Hospitals Birmingham NHS Foundation Trust; University Hospital Southampton NHS Foundation Trust; NHS Lothian; Hampshire Hospitals NHS Foundation Trust; University Hospital Coventry & Warwickshire NHS Trust; University Hospitals Bristol and Weston NHS Foundation Trust; Cambridge University Hospitals NHS Foundation Trust; NHS University Hospitals of Liverpool Group; King's College Hospital NHS Foundation Trust; East Lancashire Hospitals NHS Trust; Oxford University Hospitals NHS Foundation Trust; Cardiff and Vale University Health Board; Sheffield Teaching Hospitals NHS Foundation Trust; University Hospitals of Leicester NHS Trust; Barts Health NHS Trust; Royal Marsden NHS Foundation Trust; Leeds Teaching Hospitals NHS Trust; Newcastle upon Tyne Hospitals NHS Foundation Trust; University Hospitals Plymouth NHS Trust; University Hospitals of North Midlands NHS Trust; Nottingham University Hospitals NHS Trust
Other Contributors
Nixon, Gemma
Dasari, Bobby
Feretis, Michael
Neophytou, Christodoulos
Cyclewala, Shabnam
Roberts , Morgan
Lusuardi, Cecilia
Colucci, Nicola
Bari, Hassaan
Nunes, Quentin
Lucocq, James
Kendall, Timothy
Patel, Vishad
Hamadalnile, Albasheer
Nawaz, Aamir
Ng, Kin C
Jones, Sian
Arif, Aftab
O'Leary, Lawrence
Thakkar, Rohan
Kuzman, Matta
Clark, Tamsyn
Lakha, Adil S
Jones, Keaton
Barbur, Erol
Puri, Yogesh
Safavi, Daniel
Saleki, Mohammad
Shah, Jigar
Ijezie, Nzubechukwu
Ng, James
Chin, Sirr L
Liang, Richard
Haijibandeh, Shahin
Dasari, Bobby
Feretis, Michael
Neophytou, Christodoulos
Cyclewala, Shabnam
Roberts , Morgan
Lusuardi, Cecilia
Colucci, Nicola
Bari, Hassaan
Nunes, Quentin
Lucocq, James
Kendall, Timothy
Patel, Vishad
Hamadalnile, Albasheer
Nawaz, Aamir
Ng, Kin C
Jones, Sian
Arif, Aftab
O'Leary, Lawrence
Thakkar, Rohan
Kuzman, Matta
Clark, Tamsyn
Lakha, Adil S
Jones, Keaton
Barbur, Erol
Puri, Yogesh
Safavi, Daniel
Saleki, Mohammad
Shah, Jigar
Ijezie, Nzubechukwu
Ng, James
Chin, Sirr L
Liang, Richard
Haijibandeh, Shahin
Publication date
2025-08-22
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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.
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.
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Article