Background and aim: Besides radical resection (RR), Liver transplantation (LT) is another suggested surgical modality for hilar cholangiocarcinoma (Klatskin tumour, KT) especially for patients whose tumor is unrespectable without dissemination, although the patient outcomes remained controversial. Here, we compare the results of LT with those of RR in KT patients in our center and other studies.

Study design: A retrospective study of patients with the diagnosis of KT was conducted in our center. Overall survival (OS) and univariate analysis of prognostic factors were analyzed between LT group (n=12) and RR group (n=15). Besides, a meta-analysis of our data and other 11 relevant studies was performed.

Results: In our center, OS of LT group were 84.1%, 58.97%, and 37.60% at1-, 3-, 5 years after operation. OS in RR group at 1-, 3- and 5 years were 80.65%, 41.97% and 29.09% . Liver metastases was the only significant prognostic factor (p=0.03) between different operations. After performing meta-analysis including 703 patients, we found comparable patient survival between LT group and RR group (1-year: Rr, 1.01, 95% CI, 0.84–1.21, p=0.93; 3-year: Rr, 1.18, 95% CI, 0.80-1.72, p=0.40; 5-year: Rr, 1.39, 95% CI, 0.80–2.40, p=0.24, respectively). And the meta-analysis of subgroup about advanced UICC stage difference showed no statistical significance. No statistical significance of OS were shown between these 2 groups, but a tendency of better survival in LT group is reflected by higher Rr over longer years from the patient's pooled OS curves.

Conclusions: LT was equivalent to RR for KT in terms of patient survival, with potentially higher long-term patient survival and lower recurrence. Especially for patients with unrespectable KT or insufficient liver function, LT is of superior meaningfulness.

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