Extended hepatic resection and outcomes in intrahepatic cholangiocarcinoma.
OBJECTIVE
The aim of this report was to assess the outcome of aggressive surgical treatment for intrahepatic cholangiocarcinoma.


METHODS
From 1984 to 2001, we encountered 64 patients with intrahepatic cholangiocarcinoma. Of the 64 patients, 50 patients who underwent surgical resection with macroscopically curative objectives (78%) were reviewed for surgical procedures and outcomes.


RESULTS
Hemi- or more extensive hepatectomy was required for surgical resection in 40 patients (80%). Overall hospital morbidity and mortality rates were 50% and 8%, respectively. Curative resection with pathological free margins was achieved in 34 patients (68%). The 1-, 3-, and 5-year patient survival and tumor-free survival rates were 61.6%, 37.6%, and 22.5%; and 55%, 11%, and 11%, respectively. Among the macroscopic types, all 9 patients with intraductal growth type are alive 11-75 months after surgery. Survival rates among patients who had undergone curative resection were significantly better than those in patients who had undergone noncurative resection, even when patients with the intraductal growth type were excluded. Nodal status did not affect patient survival.


CONCLUSIONS
Although the overall survival rate after surgical resection remains unsatisfactory, long-term survival is possible through extended surgical resection with pathological free margins. Patients with the intraductal growth type of intrahepatic cholangiocarcinoma might have the best chance of being cured by surgical treatment.
Department of General Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuoh-ku, Chiba 260-8670, Japan.
Masayuki
M
Ohtsuka
Hiroshi
H
Ito
Fumio
F
Kimura
Hiroaki
H
Shimizu
Akira
A
Togawa
Hiroyuki
H
Yoshidome
Fumihiko
F
Shimamura
Yoshiaki
Y
Shimizu
Masaru
M
Miyazaki
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic / Q000601:surgery*; D018281:Cholangiocarcinoma / Q000601:surgery*; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome