Operations for intrahepatic cholangiocarcinoma: single-institution experience of 158 patients.
BACKGROUND
Intrahepatic cholangiocarcinoma (ICC) is a rare primary liver malignancy. Until now, outcomes and prognostic factors after liver resection for these tumors have not been well-documented.


METHODS
Between April 1998 and December 2006, a total of 158 patients underwent surgical exploration in our institution for intended liver resection of ICC. Prospectively collected data of patients undergoing liver resection (n = 83) were analyzed with regard to preoperative findings, operative details, perioperative morbidity and mortality, pathologic findings, outcomes measured by tumor recurrence and survival, and prognostic factors for outcomes.


RESULTS
Tumors were solitary in 47 patients. R0 resections were achieved in 53 patients. Vascular infiltration and lymph node metastasis were detected in 41% and 34%, respectively. After resection, the calculated 1-, 3-, and 5-year-survival rates were 71%, 38%, and 21%, respectively, with corresponding rates of 83%, 50%, and 30% in R0 resections. For 14 variables evaluated, only gender (p = 0.008), Union Internationale Contre le Cancer stage (p = 0.014), and R classification (p = 0.001) showed predictive value in the multivariate Cox proportional hazard regression.


CONCLUSIONS
Results presented outline that an R0 resection leads to substantially prolonged survival in ICC and represents the considerable input of the surgeon to the outcomes of these patients. Union Internationale Contre le Cancer stage remains an important factor.
Lang
Hauke
H
Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Essen, Germany. lang@ach.klinik.uni-mainz.de
Sotiropoulos
Georgios C
GC
Sgourakis
George
G
Schmitz
Klaus J
KJ
Paul
Andreas
A
Hilgard
Philip
P
Zöpf
Thomas
T
Trarbach
Tanja
T
Malagó
Massimo
M
Baba
Hideo A
HA
Broelsch
Christoph E
CE
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001650:Bile Duct Neoplasms / Q000473:pathology / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic / Q000473:pathology / Q000601:surgery*; D001662:Biliary Tract Surgical Procedures / Q000379:methods; D018281:Cholangiocarcinoma / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy; D006801:Humans; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016896:Treatment Outcome