{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T04:30:56Z","timestamp":1790397056005,"version":"4.1.0"},"reference-count":27,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2018,8,21]],"date-time":"2018-08-21T00:00:00Z","timestamp":1534809600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Patients with resectable\u00a0perihilar cholangiocarcinoma (PHC) on imaging have a substantial risk of metastatic or locally advanced disease, incomplete (R1) resection, and 90\u2010day mortality. Our aim was to develop a preoperative prognostic model to predict surgical success, defined as a complete (R0) resection without 90\u2010day mortality, in patients with resectable PHC on imaging.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Patients with PHC\u00a0who underwent exploratory laparotomy in three tertiary referral centers were identified. Multivariable logistic regression was performed to identify preoperatively available prognostic factors. A prognostic model was developed using data from two European centers and validated in one American center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 671 patients with PHC underwent exploratory laparotomy. In the derivation cohort, surgical success was achieved in 102 of 331 patients (30.8%). No resection was performed in 176 patients (53.2%) because of metastatic or locally advanced disease. Of the 155 patients (46.8%)\u00a0who underwent a resection, 38 (24.5%) had an R1\u2010resection. Of the remaining 117 (35.3%), 15 (12.8%) had 90\u2010day mortality. Independent poor prognostic factors for surgical success were identified, and a preoperative prognostic model was developed with a concordance index of 0.71. External validation showed good concordance (0.70).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Surgical success was achieved in only 30% of patients with PHC undergoing exploratory laparotomy and could be predicted by age, cholangitis, hepatic artery involvement, lymph node metastases, and Blumgart stage.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.25174","type":"journal-article","created":{"date-parts":[[2018,8,22]],"date-time":"2018-08-22T16:01:17Z","timestamp":1534953677000},"page":"469-476","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["A preoperative prognostic model to predict surgical success in patients with perihilar cholangiocarcinoma"],"prefix":"10.1002","volume":"118","author":[{"given":"Marcia P.","family":"Gaspersz","sequence":"first","affiliation":[{"name":"Department of Surgery Erasmus MC University Medical Center Rotterdam Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Buettner","sequence":"additional","affiliation":[{"name":"Department of Surgery Erasmus MC University Medical Center Rotterdam Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Roos","sequence":"additional","affiliation":[{"name":"Department of Surgery Academic Medical Center Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeroen L.A.","family":"van Vugt","sequence":"additional","affiliation":[{"name":"Department of Surgery Erasmus MC University Medical Center Rotterdam Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J.S.","family":"Coelen","sequence":"additional","affiliation":[{"name":"Department of Surgery Academic Medical Center Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaynee","family":"Vugts","sequence":"additional","affiliation":[{"name":"Department of Surgery Erasmus MC University Medical Center Rotterdam Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jimme K.","family":"Wiggers","sequence":"additional","affiliation":[{"name":"Department of Surgery Academic Medical Center Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter J.","family":"Allen","sequence":"additional","affiliation":[{"name":"Department of Surgery Memorial Sloan Kettering Cancer Center New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc G.","family":"Besselink","sequence":"additional","affiliation":[{"name":"Department of Surgery Academic Medical Center Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier R.C.","family":"Busch","sequence":"additional","affiliation":[{"name":"Department of Surgery Academic Medical Center Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric J.","family":"Belt","sequence":"additional","affiliation":[{"name":"Department of Surgery Albert Schweitzer Hospital Dordrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael I.","family":"D\u2019Angelica","sequence":"additional","affiliation":[{"name":"Department of Surgery Albert Schweitzer Hospital Dordrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald P.","family":"DeMatteo","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeroen","family":"de Jonge","sequence":"additional","affiliation":[{"name":"Department of Surgery Erasmus MC University Medical Center Rotterdam Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. 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