BACKGROUND: Current criteria for orthotopic liver transplantation (OLT) for @entity201 ( @entity201 ) remain restricted to early stage and small @entity5 , excluding @entity1 with locally advanced intrahepatic and hilar @entity201 for potential cure. The present study was undertaken to define a prognostic scoring system for risk stratification of @entity1 with intrahepatic and hilar @entity201 who might benefit from OLT and to allow expansion of current OLT criteria. STUDY DESIGN: We conducted a retrospective review of 40 @entity1 who underwent OLT for locally advanced intrahepatic and hilar @entity201 at our center between February 1985 and June 2010. Median follow-up was 3 years. Independent risk factors for @entity5 recurrence after OLT were identified using the Cox model and were assigned risk score points. Points were summed and assigned to predictive index categories: 0 to 3 for low risk, 4 to 7 for intermediate risk, and 8 to 15 for high risk. RESULTS: Seven multivariate factors predictive for @entity5 recurrence included @entity5 , perineural invasion, infiltrative growth pattern, lack of neoadjuvant and adjuvant therapy, history of primary sclerosing @entity255 , @entity5 , and @entity3 . The 5-year @entity5 recurrence-free @entity1 survival was significantly higher in low-risk (78%) compared with intermediate- (19%) and high-risk (0%) groups (p < 0.001); survival benefit was also seen in intermediate- compared with high-risk groups. CONCLUSIONS: This model was highly predictive of long-term outcomes after OLT for locally advanced intrahepatic and hilar @entity201 and can be applied clinically for risk stratification of @entity1 considered for OLT. Long-term disease recurrence-free survival was excellent in low-risk and acceptable in intermediate-risk groups, justifying the expansion of liver transplant criteria for treatment of this challenging malignancy.

Predictive index for XXXX recurrence after liver transplantation for locally advanced intrahepatic and hilar cholangiocarcinoma.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'hilar tumors', 'multifocal tumor'] @entity201 :: ('MESH:D018281', 'Disease') :: ['cholangiocarcinoma', 'CCA'] @entity3 :: ('MESH:D009362', 'Disease') :: ['lymphovascular invasion'] @entity255 :: ('MESH:D002761', 'Disease') :: ['cholangitis']
@entity5 :: (MESH:D009369,Disease) :: ['tumor']
