title: Patient outcome and prognostic factors in intrahepatic cholangiocarcinoma after hepatectomy.
abstract: OBJECTIVE
  The present study was designed to provide a systematic analysis of prognosis of patients who underwent hepatic resection for intrahepatic cholangiocarcinoma (ICC).
  
  
  METHODS
  Subjects were 36 consecutive ICC patients who had undergone hepatic resection between 1994 and 2005. The analyzed factors included various clinicopathological and surgical parameters, counts of microvessel stained for CD34 and expression of proliferative cell nuclear antigen.
  
  
  RESULTS
  The 1, 2, 3-year disease-free survival rates after surgery were 33, 18, and 0% and the 1, 3 and 5-year overall survival rates were 45, 29, and 8%. High CEA levels (> or = 10 ng/mL), excessive intraoperative blood loss (> or = 1000 mL) and presence of neighboring peritoneal dissemination were significantly associated with shorter disease-free survival (p < 0.05). High CEA levels, periductal invasion type, excessive intraoperative blood loss and non-fibrotic liver were significant factors associated with shorter overall survival (p < 0.05). Multivariate Cox proportional hazards regression model identified high CEA values, periductal invasive type, excessive intraoperative blood loss and non-fibrotic liver as significant and independent determinants of poor prognosis.
  
  
  CONCLUSIONS
  Hepatic resection with minimal blood loss followed by close follow-up is a suitable strategy for management of ICC patients with poor prognostic factors.
authors.affiliation: Division of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. a-nanasm@net.nagasaki-u.ac.jp
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nanashima
authors.forename: Yorihisa
authors.initials: Y
authors.lastname: Sumida
authors.forename: Takafumi
authors.initials: T
authors.lastname: Abo
authors.forename: Toshiya
authors.initials: T
authors.lastname: Nagasaki
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Takeshita
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Fukuoka
authors.forename: Terumitsu
authors.initials: T
authors.lastname: Sawai
authors.forename: Kenji
authors.initials: K
authors.lastname: Tanaka
authors.forename: Toru
authors.initials: T
authors.lastname: Yasutake
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nagayasu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000401:mortality* / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D018281:Cholangiocarcinoma / Q000401:mortality* / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D016016:Proportional Hazards Models; D016896:Treatment Outcome