To investigate the prognostic factors of patients with perihilar cholangiocarcinoma (PHC) after surgery.

Clinical data of 160 patients with PHC who underwent surgical resection in Lihuili Hospital Affiliated to Ningbo University from January 2002 to December 2019 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Survival analysis was conducted by Kaplan-Meier method and Log-rank test. The prognostic factors were analyzed by Cox proportional hazards regression model.

Among 160 patients,86 patients were male and 74 female, aged from 30 to 83 years, with a median age of 63 years. 42 patients were classified as Bismuth-Corlette type Ⅰ and Ⅱ, and 118 cases were type Ⅲ and Ⅳ. 16 patients underwent simple extrahepatic bile duct resection, 56 cases of middle hepatic resection, 88 cases of extensive liver resection.68 cases underwent combined vascular resection and reconstruction and 138 cases of R0 resection, respectively. The 1-, 3- and 5-year overall survival rates of PHC patients were 70.3%, 33.5% and 24.2%, and the 1-, 3- and 5-year recurrence-free survival rates were 56.7%, 36.6% and 33.5%, respectively. Multivariate Cox analysis showed that low-grade differentiation, lymph node metastasis and R1 resection were the independent risk factors for the overall survival and recurrence-free survival of PHC patients after surgery (HR=1.510, 2.346, 1.963 and 1.665, 2.862, 3.443; P<0.05).

Tumor differentiation, lymph node metastasis and degree of radical resection are closely correlated with the postoperative prognosis of PHC patients.