Is Repeat Resection for Recurrent Intrahepatic Cholangiocarcinoma Warranted? Outcomes of an International Analysis
- 09.02.2024
- Hepatobiliary Tumors
Erschienen in:
- Verfasst von
- Matthew L. Holzner, MD, MSc
- Vincenzo Mazzaferro, MD, PhD
- Michele Droz Dit Busset, MD
- Luca Aldrighetti, MD, PhD
- Francesca Ratti, MD
- Kiyoshi Hasegawa, MD, PhD
- Junichi Arita, MD, PhD
- Gonzalo Sapisochin, MD, PhD
- Phillipe Abreu, MD, PhD
- Wenzel Schoning, MD
- Mortiz Schmelzle, MD
- Nora Nevermann, MD
- Johann Pratschke, MD
- Sander Florman, MD
- Karim Halazun, MD
- Myron E. Schwartz, MD
- Parissa Tabrizian, MD, MSc
- Erschienen in
- Annals of Surgical Oncology | Ausgabe 7/2024
Abstract
Background
Recurrence of intrahepatic cholangiocarcinoma (ICC) after liver resection (LR) remains high, and optimal therapy for recurrent ICC is challenging. Herein, we assess the outcomes of patients undergoing repeat resection for recurrent ICC in a large, international multicenter cohort.
Patients and Methods
Outcomes of adults from six large hepatobiliary centers in North America, Europe, and Asia with recurrent ICC following primary LR between 2001 and 2015 were analyzed. Cox models determined predictors of post-recurrence survival.
Results
Of patients undergoing LR for ICC, 499 developed recurrence. The median time to recurrence was 10 months, and 47% were intrahepatic. Overall 3-year post-recurrence survival rate was 28.6%. In total, 121 patients (25%) underwent repeat resection, including 74 (61%) repeat LRs. Surgically treated patients were more likely to have solitary intrahepatic recurrences and significantly prolonged survival compared with those receiving locoregional or systemic therapy alone with a 3-year post-recurrence survival rate of 47%. Independent predictors of post-recurrence death included time to recurrence < 1 year [HR 1.66 (1.32–2.10), p < 0.001], site of recurrence [HR 1.74 (1.28–2.38), p < 0.001], macrovascular invasion [HR 1.43 (1.05–1.95), p = 0.024], and size of recurrence > 3 cm [HR 1.68 (1.24–2.29), p = 0.001]. Repeat resection was independently associated with decreased post-recurrence death [HR 0.58 0.43–0.78), p < 0.001].
Conclusions
Repeat resection for recurrent ICC in select patients can result in extended survival. Thus, challenging the paradigm of offering these patients locoregional or chemo/palliative therapy alone as the mainstay of treatment.
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- Titel
- Is Repeat Resection for Recurrent Intrahepatic Cholangiocarcinoma Warranted? Outcomes of an International Analysis
- Verfasst von
-
Matthew L. Holzner, MD, MSc
Vincenzo Mazzaferro, MD, PhD
Michele Droz Dit Busset, MD
Luca Aldrighetti, MD, PhD
Francesca Ratti, MD
Kiyoshi Hasegawa, MD, PhD
Junichi Arita, MD, PhD
Gonzalo Sapisochin, MD, PhD
Phillipe Abreu, MD, PhD
Wenzel Schoning, MD
Mortiz Schmelzle, MD
Nora Nevermann, MD
Johann Pratschke, MD
Sander Florman, MD
Karim Halazun, MD
Myron E. Schwartz, MD
Parissa Tabrizian, MD, MSc
- Publikationsdatum
- 09.02.2024
- Verlag
- Springer International Publishing
- Erschienen in
-
Annals of Surgical Oncology / Ausgabe 7/2024
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681 - DOI
- https://doi.org/10.1245/s10434-024-14975-w
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