title: The impact of surgical treatment and poor prognostic factors for patients with intrahepatic cholangiocarcinoma: retrospective analysis of 60 patients.
abstract: BACKGROUND
  Intrahepatic cholangiocarcinoma (ICC) is a primary adenocarcinoma of the liver arising from the intrahepatic bile duct. Hepatectomy with extensive lymph node dissection is the standard treatment for ICC.
  
  
  METHODS
  Sixty patients with ICC who underwent hepatectomy in our institution between 1986 and 2005 were investigated to determine prognostic factors and to evaluate the impact of surgical treatment for ICC using univariate and multivariate analyses.
  
  
  RESULTS
  The overall survival rate of the R0 resection group (n=43) was significantly higher than that of the R1/2 group (n=17). However, in patients with lymph node metastasis (n=24), R0 resection had no survival impact. According to multivariate analysis, the independent factors of poor prognosis were: the presence of lymph node metastasis, lymphatic invasion, poor differentiation and R1/2 resection.
  
  
  CONCLUSIONS
  R0 resection can provide prolonged survival for patients with ICC. Patients with lymph node metastasis, lymphatic invasion, or poorly differentiated ICC have poor prognosis after operation and additional treatment, such as adjuvant chemotherapy, is recommended.
authors.affiliation: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan. yamashi@surg2.med.kyushu-u.ac.jp
authors.forename: Yo-ichi
authors.initials: Y
authors.lastname: Yamashita
authors.forename: Akinobu
authors.initials: A
authors.lastname: Taketomi
authors.forename: Kazutoyo
authors.initials: K
authors.lastname: Morita
authors.forename: Takasuke
authors.initials: T
authors.lastname: Fukuhara
authors.forename: Shigeru
authors.initials: S
authors.lastname: Ueda
authors.forename: Kensaku
authors.initials: K
authors.lastname: Sanefuji
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Iguchi
authors.forename: Hiroto
authors.initials: H
authors.lastname: Kayashima
authors.forename: Keishi
authors.initials: K
authors.lastname: Sugimachi
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Maehara