https://www.selleckchem.com/products/AS703026.html 5% of hepatic recurrences, and the median OS was significantly higher than for patients treated with systemic treatment alone (P<0.001). Combining hepatectomy and IORFA could provide comparable survival rates for patients with multiple unresectable CRLM compared to those with resectable CRLM treated with hepatectomy alone. Combining hepatectomy and IORFA could provide comparable survival rates for patients with multiple unresectable CRLM compared to those with resectable CRLM treated with hepatectomy alone. While a certain degree of tumor infiltration of the portal vein is common in patients with perihilar cholangiocarcinoma (pCCA) scheduled for surgery, complete tumor-associated portal vein occlusion (PVO) is less frequently observed. Here, we analyzed the impact of PVO on perioperative and oncological outcomes in pCCA patients. Between 2010 and 2019, 127 patients with pCCA underwent surgery in curative intent at our department of which 17.3% (22/127) presented with PVO. Extensive group comparisons were conducted and the association of cancer-specific (CSS) and disease-free survival (DFS) with PVO and other clinico-pathological characteristics were assessed using Cox regression models. Patients without PVO showed a median CSS of 65 months (3-year-CSS=64%, 5-year-CSS=53%) compared to 31 months (3-year-CSS=43%, 5-year-CSS=17%) in patients with PVO (p=0.025 log rank). Patients with PVO did also display significant perioperative mortality (22.7%, 5/22) compared to patients without PVO (14.3%, 15/105, p=0.323). Further, PVO (CSS HR=5.25, p=0.001; DFS HR=5.53, p=0.001) was identified as independent predictors of oncological outcome. PVO has been identified as an important prognostic marker playing a role in inferior oncological outcome in patients with pCCA. As PVO is also associated with notable perioperative mortality, surgical therapy should be considered carefully in pCCA patients. PVO has been identified as an impor