Postoperative radiotherapy in locally advanced hepatic hilar cholangiocarcinoma

Objective: To evaluate the outcome of radiotherapy (RT) in locally advanced hepatic hilar cholangiocarcinoma. Methods: During March 1992 to December 1997, 47 patients who had positive microscopic surgical margins after surgery were treated by postoperative radiotherapy (S+RT, 28 patients, with a median dose of 50 Gy, 45–62 Gy) and surgery alone (S, 19 patients). The median follow-up was 30 months (4–113 months). Results: The overall 5-year survival rate was 28%, with a median survival length of 19.6 months while 5-year survival rates of S+RT group and S group were 34% and 14%, with median survival lengths of 29 and 10 months respectively (P=0.015). The occurrence rate of complications was 11% in either group. Conclusion: Postoperative radiotherapy significantly prolongs survival lengths in patients with hepatic hilar cholangio- carcinoma who had positive microscopic surgical margins. Radiation toxicities are tolerable.