To investigate the clinical efficacy of surgical resection for hilar cholangiocarcinoma (HCCA) and the impact factors for the prognosis.

Clinical data of 52 patients with HCCA who underwent surgical resection in Fuzhou General Hospital of PLA from January 2009 to December 2013 were retrospectively analyzed. Among them, 31 patients were male and 21 were female, aged from 34 to 80 years, with a median age of 63 years. The informed consents of all patients were obtained and the local ethical committee approval was received. The survival, tumor recurrence and metastasis of the patients were observed. Survival ananlysis and univariate analysis of the prognosis was conducted with Kaplan-Meier method and Log-rank test. The multivariate analysis was conducted with Cox's proportional hazard model.

During the follow-up period, 45 patients died of tumor recurrence and metastasis, and 1 died of the upper gastrointestinal bleeding. The overall median survival time of 52 patients was 21 months, and the 1-, 3-, and 5-year survival rates were 69.2%, 30.8% and 11.5%, respectively. Univariate analysis indicated that tumor diameter, degree of radical resection of tumor, lymph node metastasis, TNM stage and tumor differentiation degree were the impact factors for the prognosis of HCCA patients after surgical resection (χ²=3.902, 8.820, 8.926, 4.245, 6.071; P<0.05). Multivariate analysis revealed that R0 resection, negative lymph node, TNM stage Ⅰ-Ⅱ and high differentiation of tumor were the independent protective factors for the prognosis of HCCA patients after surgical resection (HR=0.364, 0.379, 0.546, 0.498; 95%CI: 0.178-0.743, 0.190-0.756, 0.303-0.984, 0.263-0.942; P<0.05).

The prognosis of HCCA patients is poor. Radical resection, standardized lymph node dissection and tumor malignancy are the key factors affecting the surgical efficacy.