title: Treatment outcomes and prognostic factors of intrahepatic cholangiocarcinoma.
abstract: The aim of the present study was to determine the treatment outcome and             prognostic factors for survival in patients with peripheral intrahepatic cholangiocarcinoma             (ICC). A retrospective chart review was performed for patients diagnosed with             ICC between 2000 and 2009 at a single institution. We identified a total of 105             patients with ICC. Among them, 63.8% were older than 60 years of age, 50.5% were             male and 88.6% were Caucasian. By preoperative imaging approximately half of the             patients (50.5%) were surgical candidates and underwent resection. The other half             of the patients (49.5%) were unresectable. The unresectable group received chemoradiotherapy             (53%) and transarterial chemoembolization (7.7%) as palliative treatments while             23.0% of the patients (12/52) received best supportive care alone. The median             survival rates were 16.1 months (13.1‑19.2) for the entire cohort, 27.6 months             (17.7-37.6) for curative resection, 12.9 months (6.5-19.2) for palliative chemoradiotherapy             and 4.9 months (0.4-9.6) for best supportive care (p<0.001). Independent predictors             on multivariate analysis were advanced stage at diagnosis and treatment received.             In those patients who underwent resection, advanced AJCC stage and presence of             microvascular invasion were also independent predictors of poor survival. We concluded             that surgery offers the most beneficial curative option and outcome, emphasizing             the importance of resectability as a major prognostic factor. The present study             also revealed that use of chemoradiotherapy in the adjuvant setting failed to             improve survival but its palliative use in those patients with unresectable ICC             offered a modest survival advantage over best supportive care. The overriding             factors influencing outcome were stage and the presence of microvascular invasion             on pathology.
authors: Department of Medicine, University of Florida, Gainesville, FL,                     USA.
authors: Renumathy
authors: R
authors: Dhanasekaran
authors: Alan W
authors: AW
authors: Hemming
authors: Ivan
authors: I
authors: Zendejas
authors: Thomas
authors: T
authors: George
authors: David R
authors: DR
authors: Nelson
authors: Consuelo
authors: C
authors: Soldevila-Pico
authors: Roberto J
authors: RJ
authors: Firpi
authors: Giuseppe
authors: G
authors: Morelli
authors: Virginia
authors: V
authors: Clark
authors: Roniel
authors: R
authors: Cabrera
mesh_terms: D000368:Aged; D001650:Bile Duct Neoplasms; D001653:Bile Ducts, Intrahepatic; D018281:Cholangiocarcinoma / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D055806:Microvessels / Q000473:pathology; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome