The impact of surgical treatment and poor prognostic factors for patients with intrahepatic cholangiocarcinoma: retrospective analysis of 60 patients.
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.
Yamashita
Yo-ichi
Y
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
Taketomi
Akinobu
A
Morita
Kazutoyo
K
Fukuhara
Takasuke
T
Ueda
Shigeru
S
Sanefuji
Kensaku
K
Iguchi
Tomohiro
T
Kayashima
Hiroto
H
Sugimachi
Keishi
K
Maehara
Yoshihiko
Y