title: Clinicopathological and prognostic analysis of 429 patients with intrahepatic cholangiocarcinoma.
abstract: OBJECTIVE
  To understand the clinicopathological characteristics and treatment selections and improve survival and provide valuable information for patients with intrahepatic cholangiocarcinoma (ICC).
  
  
  METHODS
  We retrospectively evaluated 5311 liver cancer patients who received resection between October 1999 and December 2003. Of these, 429 (8.1%) patients were diagnosed with ICC, and their clinicopathological, surgical, and survival characteristics were analyzed.
  
  
  RESULTS
  Upper abdominal discomfort or pain (65.0%), no symptoms (12.1%), and hypodynamia (8.2%) were the major causes for medical attention. Laboratory tests showed 198 (46.4%) patients were HBsAg positive, 90 (21.3%) had alpha-fetoprotein > 20 microg/L, 50 (11.9%) carcinoembryonic antigen > 10 microg/L, and 242 (57.5%) carbohydrate antigen 19-9 (CA19-9) > 37 U/mL. Survival data was available for 329 (76.7%) patients and their mean survival time was 12.4 mo. The overall survival of the patients with R0, R1 resection and punching exploration were 18.3, 6.6 and 5.6 mo, respectively. Additionally, CA19-9 > 37 U/mL was associated with lymph node metastases, but inversely associated with cirrhosis. Multivariate analysis indicated that radical resection, lymph node metastases, macroscopic tumor thrombi and size, and CA19-9 were associated with prognosis.
  
  
  CONCLUSIONS
  Surgical radical resection is still the most effective means to cure ICC. Certain laboratory tests (such as CA19-9) can effectively predict the survival of the patients with ICC.
authors.affiliation: Department of Special Treatment, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, 225 Changhai Road, Shanghai 200438, China.
authors.forename: Wei-Feng
authors.initials: WF
authors.lastname: Shen
authors.forename: Wei
authors.initials: W
authors.lastname: Zhong
authors.forename: Feng
authors.initials: F
authors.lastname: Xu
authors.forename: Tong
authors.initials: T
authors.lastname: Kan
authors.forename: Li
authors.initials: L
authors.lastname: Geng
authors.forename: Feng
authors.initials: F
authors.lastname: Xie
authors.forename: Cheng-Jun
authors.initials: CJ
authors.lastname: Sui
authors.forename: Jia-Mei
authors.initials: JM
authors.lastname: Yang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D001653:Bile Ducts, Intrahepatic / Q000473:pathology* / Q000601:surgery; D014408:Biomarkers, Tumor / Q000378:metabolism; D018281:Cholangiocarcinoma / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor