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Erschienen in: World Journal of Surgery 4/2019

06.12.2018 | Original Scientific Report

Surgical Resection for Recurrent Intrahepatic Cholangiocarcinoma

verfasst von: Fabian Bartsch, Markus Paschold, Janine Baumgart, Maria Hoppe-Lotichius, Stefan Heinrich, Hauke Lang

Erschienen in: World Journal of Surgery | Ausgabe 4/2019

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Abstract

Background

Although after R0 resection of intrahepatic cholangiocarcinoma (ICC) recurrence is frequent, most guidelines do not address strategies for this. The aim of this study was to analyze the outcome of repeated resection and to determine criteria when repeated resection is reasonable.

Methods

Between 2008 and 2016, we consecutively collected all cases of ICC (n = 176) in a prospective database and further analyzed them with a focus on tumor recurrence, its surgical treatment, overall survival and recurrence-free survival.

Results

Overall, a total of 22 explorations were performed for recurrent ICC in 17 patients. Resection rate was 18 repeated resections in 13 patients. Three patients underwent repeated resection twice and one patient three times. Recurrence was solitary in 7 patients and multifocal in 11 re-resected cases. Median overall survival (OS) of patients who underwent repeated resection was 65.2 months (interquartile range 37–126.5) with a 5-year OS rate of 62%, calculated from primary resection. Patients who underwent repeated resections had a significant better OS compared to those receiving chemotherapy, transarterial chemoembolization, selective internal radiotherapy, radiofrequency ablation or best supportive care (p < 0.001).

Conclusion

Repeated resection of recurrent ICC is reasonable and associated with an improved survival. Re-exploration should be considered as long as resection is technically possible.
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Metadaten
Titel
Surgical Resection for Recurrent Intrahepatic Cholangiocarcinoma
verfasst von
Fabian Bartsch
Markus Paschold
Janine Baumgart
Maria Hoppe-Lotichius
Stefan Heinrich
Hauke Lang
Publikationsdatum
06.12.2018
Verlag
Springer International Publishing
Erschienen in
World Journal of Surgery / Ausgabe 4/2019
Print ISSN: 0364-2313
Elektronische ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-018-04876-x

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