Node-positive cholangiocarcinoma is a poor prognostic indicator of survival. Metastatic disease precludes resection and has a poor prognosis. The common early pattern of spread is to regional lymph nodes and to distant sites in the liver.
The 5-year survival for surgical resection alone ranges from 20% to 43%.[48]Yeh CN, Jan YY, Yeh TS, et al. Hepatic resection of the intraductal papillary type of peripheral cholangiocarcinoma. Ann Surg Oncol. 2004;11:606-611.
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[49]Nakagohri T, Asano T, Kinoshita H, et al. Aggressive surgical resection for hilar-invasive and peripheral intrahepatic cholangiocarcinoma. World J Surg. 2003;27:289-293.
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[50]Isaji S, Kawarada Y, Taoka H, et al. Clinicopathological features and outcome of hepatic resection for intrahepatic cholangiocarcinoma in Japan. J Hepatobiliary Pancreat Surg. 1999;6:108-116.
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[51]Berdah SV, Delpero JR, Garcia S, et al. A western surgical experience of peripheral cholangiocarcinoma. Br J Surg. 1996;83:1517-1521.
http://www.ncbi.nlm.nih.gov/pubmed/9014664?tool=bestpractice.com
For surgical resection with chemotherapy, the 5-year survival rate is 26%. The response rate to chemotherapy alone is <15%.[100]Furuse J, Okusaka T, Funakoshi A, et al. Early phase II study of uracil-tegafur plus doxorubicin in patients with unresectable advanced biliary tract cancer. Jpn J Clin Oncol. 2006;36:552-556.
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For liver transplant, there is a recurrence rate of 51% within 2 years of the procedure.[101]Meyer CG, Penn I, James L. Liver transplantation for cholangiocarcinoma results in 207 patients. Transplantation. 2000;69:1633-1637.
http://www.ncbi.nlm.nih.gov/pubmed/10836374?tool=bestpractice.com