Original Research
Visceral infiltration of intrahepatic cholangiocarcinoma is most prognostic after curative resection - Retrospective cohort study of 102 consecutive liver resections from a single center

https://doi.org/10.1016/j.ijsu.2018.05.027Get rights and content
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Highlights

  • An aggressive surgical approach achieves a high rate of R0 resections even in advanced ICC.

  • Visceral infiltration is an independent predictor for OS for ICC after curative resection.

  • N-stage, visceral infiltration and UICC stage were significant in the univariate analysis for OS.

  • Tumor size, N-stage, R-stage and M-stage were independent predictors for RFS after resection of ICC.

Abstract

Introduction

Intrahepatic cholangiocarcinoma (ICC) is a rare malignancy, and therefore large unicenter series on the surgical outcome are rare in the literature, and prognostic factors for overall survival in the literature vary widely.

Methods

All patients who underwent surgery for ICC were prospectively recorded. The type of resection, operative details, histological results, morbidity, mortality, overall and recurrence-free survivals as well as prognostic factors were assessed. Prognostic factors were examined by univariate and multivariate analyses. P-values <0.05 were considered significant.

Results

Between January 2008 and December 2015, 102 patients underwent a resection with curative intent and were included in this analysis. Major and extended hepatectomies were performed in 19 and 53 cases, respectively. Twenty-eight patients had additional vascular and 35 patients additional visceral resections. R0-resections were achieved in 87 patients (85.3%). Median recurrence-free and overall survivals were 9.3 and 20.8 months, respectively. N-stage, infiltration of surrounding structures and UICC stage were significant prognostic factors in the univariate analysis. Multivariate analysis depicted only visceral infiltration (p = 0.011) as independent predictor for overall survival, and tumor size (p < 0.001), N-stage (p = 0.007), R-stage (p = 0.008) and M-stage (p = 0.009) for recurrence-free survival.

Conclusion

An aggressive surgical approach achieves a high rate of R0 resections even in advanced ICC. Visceral infiltration is an independent predictor for overall survival for ICC after curative resection.

Keywords

Intrahepatic cholangiocarcinoma
Cholangiocarcinoma
Liver surgery
Survival
Predictors of survival

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1

Both authors equally contributed to this manuscript.