title: Thermal ablation versus repeated hepatic resection for recurrent intrahepatic cholangiocarcinoma.
abstract: BACKGROUND
  Repeated hepatic resection (HR) and thermal ablation therapy (TAT) are increasingly being used to treat recurrent intrahepatic cholangiocarcinoma (RICC). This study compared the efficacy and safety of these procedures for RICC treatment.
  
  
  METHODS
  Patients were studied retrospectively after curative resection of RICCs by repeated HR (n = 32) or TAT (n = 77). Treatment effectiveness and prognosis were compared between the two treatment groups.
  
  
  RESULTS
  The repeated HR and TAT groups did not differ in their overall survival (OS; p = 0.996) or disease-free survival (DFS; p = 0.692) rates. However, among patients with recurrent tumors >3 cm in diameter, patients in the repeated HR group had a higher OS rate than patients in the TAT group (p = 0.037). The number of recurrent tumors and the recurrence interval were significant prognostic factors for OS. The major complications incidence rate was greater in the repeated HR group than in the TAT group (p < 0.001).
  
  
  CONCLUSIONS
  Repeated HR and TAT are both effective treatments for RICC with similar overall efficacies. TAT should be preferred in any cases when the RICC is ≤3 cm in diameter and technically feasible. However, for large tumors (>3 cm), repeated HR may be a better choice.
authors.affiliation: Minimal Invasion Therapy Department 1, Eastern Hepatobiliary Surgery Hospital, Shanghai, China.
authors.forename: Shao-Jun
authors.initials: SJ
authors.lastname: Zhang
authors.forename: Peng
authors.initials: P
authors.lastname: Hu
authors.forename: Neng
authors.initials: N
authors.lastname: Wang
authors.forename: Qiang
authors.initials: Q
authors.lastname: Shen
authors.forename: Ai-Xue
authors.initials: AX
authors.lastname: Sun
authors.forename: Ming
authors.initials: M
authors.lastname: Kuang
authors.forename: Guo-Jun
authors.initials: GJ
authors.lastname: Qian
mesh_terms: D000328:Adult; D000368:Aged; D001650:Bile Duct Neoplasms; D001653:Bile Ducts, Intrahepatic; D017115:Catheter Ablation / Q000401:mortality*; D018281:Cholangiocarcinoma / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000401:mortality*; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate