Survival analysis of intrahepatic cholangiocarcinoma after resection.
BACKGROUND
Intrahepatic cholangiocarcinoma (ICC) is the second most common primary hepatic malignancy, but the studies for the outcome after resection of ICC are rare. The aim of this study was to elucidate outcomes and prognostic factors of ICC in patients undergoing hepatic resection.


METHODS
A retrospective study was conducted with a total of 63 patients who underwent surgical resection with curative intent for ICC. We performed the survival analysis with preoperative and postoperative clinicopathologic factors according to the clinical outcome.


RESULTS
The cumulative 1-, 3-, and 5-year survival rates were 68.2, 50.5, and 31.8%, respectively. Univariate analysis revealed that patient's old age, high preoperative carbohydrate antigen 19-9 (CA19-9) level, major vessel invasion, T classification, lymph node metastasis, lymphatic invasion, perineural invasion, intrahepatic metastasis, and narrow resection margin were statistically significant. By multivariate analysis, patient's old age, high preoperative CA19-9 level, lymphatic invasion, and narrow resection margin were independent dismal prognostic factors. The preoperative CA19-9 level shows a significant correlation with some histopathologic factors including major vessel invasion, bile duct invasion, and perineural invasion.


CONCLUSIONS
Preoperative CA19-9 level was a valuable clinical factor for predicting histopathologic invasiveness as well as clinical outcome. An adequate resection margin was the only modifiable factor by a surgeon during hepatic resection for ICC.
Cho
Seong Yeon
SY
National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea.
Park
Sang-Jae
SJ
Kim
Seong Hoon
SH
Han
Sung-Sik
SS
Kim
Young-Kyu
YK
Lee
Kwang-Woong
KW
Lee
Soon-Ae
SA
Hong
Eun Kyung
EK
Lee
Woo Jin
WJ
Woo
Sang Myung
SM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001650:Bile Duct Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D001653:Bile Ducts, Intrahepatic / Q000473:pathology* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D018281:Cholangiocarcinoma / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome