Characterization of intrahepatic cholangiocarcinoma after curative resection: outcome, prognostic factor, and recurrence

Abstract

BackgroundIntrahepatic cholangiocarcinoma (ICC) is a relatively rare subtype of cholangiocarcinoma. The study herein gathered experience of surgical treatment for ICC, and aimed to analyze the prognosis of patients who had received curative-intent liver resection.MethodsA total of 216 patients who had undergone curative-intent liver resection for ICC between January 1977 and December 2014 was retrospectively reviewed.ResultsOverall, the rates of 5-years recurrence-free survival (RFS) and overall survival (OS) were 26.1 and 33.9% respectively. Based on multivariate analysis, four independent adverse prognostic factors including morphology patterns, maximum tumor size > 5 cm, pathological lymph node involvement, and vascular invasion were identified as affecting RFS after curative-intent liver resection for ICC. Among patients with cholangiocarcinoma recurrence, only 27 (16.9%) were able to receive surgical resection for recurrent cholangiocarcinoma that had a significantly better outcome than the remaining patients.ConclusionDespite curative resection, the general outcome of patients with ICC is still unsatisfactory because of a high incidence of cholangiocarcinoma recurrence after operation. Tumor factors associated with cholangiocarcinoma remain crucial for the prognosis of patients with ICC after curative liver resection. Moreover, aggressive attitude toward repeat resection for the postoperative recurrent cholangiocarcinoma could provide a favorable outcome for patients.

Perineural invasion as a prognostic factor for intrahepatic cholangiocarcinoma after curative resection and a potential indication for postoperative chemotherapy: a retrospective cohort study

“…Comparatively speaking, fewer studies report the meaning of PNI to RFS. As far as we concerned, only studies from Kang et al [31] and Chan et al [32] showed PNI had no influence in RFS through the univariate and multivariate analyses in their case-control studies, which are not consistent with our results. However, we did go further by using study design of historical cohort, K-M curves and the univariate and multivariate analyses to make a more convincible evidence.…”

“…Ahn et al [30] retrospectively analyzed 292 R0-resected ICC patients and the univariate and multivariate survival analyses of OS showed PNI as an independent significant risk factor against long-term survival, which is consistent with our results. However, some studies revealed quite different results that did not support PNI as one [31,32]. Comparatively speaking, fewer studies report the meaning of PNI to RFS.…”

Expression of long non-coding RNA ANRIL predicts a poor prognosis in intrahepatic cholangiocarcinoma

“…CCA is a deadly cancer worldwide waiting for innovative biomarkers and therapeutic strategies to improve the survival of patients 1,2 . In iCCA, several clinical variables have been identified as important prognostic factors after surgical resection for curative intent, including tumor size, pathological lymph node involvement and vascular invasion 1,29,30 . Omics approaches (e.g.…”

A case of Trousseau’s syndrome due to intrahepatic cholangiocarcinoma with an extremely high level of CA19-9

“…However, the current patient underwent right hepatectomy and received systemic chemotherapy; she was successfully discharged and has been followed without further thrombosis during the 6 months after surgery. Because most patients of Trousseau's syndrome and intrahepatic cholangiocarcinoma are at an advanced stage by the time of diagnosis, it is difficult for them to undergo curative treatment [2,3,7,9]. Therefore, the prognosis of the patients with Trousseau's syndrome and intrahepatic cholangiocarcinoma is very poor [3,7,8].…”