Predictors of Cure of Intrahepatic Cholangiocarcinoma After Hepatic Resection

Anticancer Res. 2017 Dec;37(12):6971-6975. doi: 10.21873/anticanres.12164.

Abstract

Background/aim: Intrahepatic cholangiocarcinoma (ICC) is the second most common primary liver cancer after hepatocellular carcinoma, and has a poor prognosis. Surgical resection is the only option for a cure of ICC. Here we attempted to define the cure rate after hepatic resection for ICC and to identify the predictors for a cure.

Patients and methods: Among the 96 patients who underwent R0 resections for primary ICC between 1990 and 2011 at the Kumamoto University Hospital and Kyushu University Hospital, those who were followed for ≥5 years after surgery were enrolled. "Cure" was defined as recurrence-free survival (RFS) of ≥5 years after surgery.

Results: A total of 81 patients were eligible. A cure was achieved in 37 patients (45.7%). The 5-year overall survival and RFS rates were 55.0% and 41.7%, respectively. A multivariate logistic regression analysis identified the absence of lymph node metastasis (relative risk (RR) 7.5, p=0.011) and the absence of microvascular invasion (RR 5.5, p=0.0137) as the independent predictors of achieving a cure.

Conclusion: R0 resections achieved a cure in 45.7% of this series of ICC patients. The predictors of a cure identified here, i.e., absence of lymph node metastasis and absence of microvascular invasion, could contribute to the selection of patients who are not candidates for adjuvant chemotherapy.

Keywords: Intrahepatic cholangiocarcinoma; hepatic resection.

MeSH terms

  • Aged
  • Bile Duct Neoplasms / pathology
  • Bile Duct Neoplasms / surgery*
  • Bile Ducts, Intrahepatic / pathology
  • Bile Ducts, Intrahepatic / surgery*
  • Cholangiocarcinoma / pathology
  • Cholangiocarcinoma / surgery*
  • Disease-Free Survival
  • Female
  • Hepatectomy / methods*
  • Humans
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Outcome Assessment, Health Care / methods
  • Outcome Assessment, Health Care / statistics & numerical data
  • Prognosis