title: Operations for intrahepatic cholangiocarcinoma: single-institution experience of 158 patients.
abstract: 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.
authors.affiliation: Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Essen, Germany. lang@ach.klinik.uni-mainz.de
authors.forename: Hauke
authors.initials: H
authors.lastname: Lang
authors.forename: Georgios C
authors.initials: GC
authors.lastname: Sotiropoulos
authors.forename: George
authors.initials: G
authors.lastname: Sgourakis
authors.forename: Klaus J
authors.initials: KJ
authors.lastname: Schmitz
authors.forename: Andreas
authors.initials: A
authors.lastname: Paul
authors.forename: Philip
authors.initials: P
authors.lastname: Hilgard
authors.forename: Thomas
authors.initials: T
authors.lastname: Zöpf
authors.forename: Tanja
authors.initials: T
authors.lastname: Trarbach
authors.forename: Massimo
authors.initials: M
authors.lastname: Malagó
authors.forename: Hideo A
authors.initials: HA
authors.lastname: Baba
authors.forename: Christoph E
authors.initials: CE
authors.lastname: Broelsch
mesh_terms: 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