title: First and repeat liver resection for primary and recurrent intrahepatic cholangiocarcinoma.
abstract: BACKGROUND
  Recurrence after resection of intrahepatic cholangiocarcinoma (ICC) remains common. The present study sought to evaluate risk factors for recurrence and the results of repeat liver resection (RLR) for recurrent ICC.
  
  
  METHODS
  Between 1997 and 2012, clinical data and outcomes of 125 consecutive patients undergoing liver resection for ICC were retrospectively analyzed.
  
  
  RESULTS
  The rate of R0 resection was 89% (n = 110). Overall median survival was 35 months, and 1-, 3-, and 5-year actuarial survival rates were 80%, 48%, and 28%, respectively. Recurrence occurred in 76 patients (63.5%) and was intrahepatic only for 39 patients (51%). Tumor size greater than 5 cm was identified as an independent risk factor for recurrence (P ≤ .0001). RLR for recurrent ICC was feasible in 10 patients (25%) with a median survival after recurrence of 25 months (16 to 76).
  
  
  CONCLUSIONS
  Tumor size more than 5 cm represents an independent risk factor for recurrence after resection of ICC. RLR in case of recurrent ICC, when feasible, is associated with longer overall survival.
authors.affiliation: Department of Surgery and Liver Transplantation, Hopital Saint Eloi-Hopitaux Universitaires de Montpellier, Université de Montpellier 1, 80, Avenue Augustin Fliche, 34295 Montpellier Cedex 5, France. Electronic address: fr-souche@chu-montpellier.fr.
authors.forename: Regis
authors.initials: R
authors.lastname: Souche
authors.affiliation: Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Pole des Pathologies Digestives, Hepatiques et de la Transplantation, Hopital de Hautepierre-Hopitaux Universitaires de Strasbourg, Université de Strasbourg, Strasbourg, France.
authors.forename: Pietro
authors.initials: P
authors.lastname: Addeo
authors.affiliation: Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Pole des Pathologies Digestives, Hepatiques et de la Transplantation, Hopital de Hautepierre-Hopitaux Universitaires de Strasbourg, Université de Strasbourg, Strasbourg, France.
authors.forename: Elie
authors.initials: E
authors.lastname: Oussoultzoglou
authors.affiliation: Department of Surgery and Liver Transplantation, Hopital Saint Eloi-Hopitaux Universitaires de Montpellier, Université de Montpellier 1, 80, Avenue Augustin Fliche, 34295 Montpellier Cedex 5, France.
authors.forename: Astrid
authors.initials: A
authors.lastname: Herrero
authors.affiliation: Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Pole des Pathologies Digestives, Hepatiques et de la Transplantation, Hopital de Hautepierre-Hopitaux Universitaires de Strasbourg, Université de Strasbourg, Strasbourg, France.
authors.forename: Edoardo
authors.initials: E
authors.lastname: Rosso
authors.affiliation: Department of Surgery and Liver Transplantation, Hopital Saint Eloi-Hopitaux Universitaires de Montpellier, Université de Montpellier 1, 80, Avenue Augustin Fliche, 34295 Montpellier Cedex 5, France.
authors.forename: Francis
authors.initials: F
authors.lastname: Navarro
authors.affiliation: Department of Surgery and Liver Transplantation, Hopital Saint Eloi-Hopitaux Universitaires de Montpellier, Université de Montpellier 1, 80, Avenue Augustin Fliche, 34295 Montpellier Cedex 5, France.
authors.forename: Jean Michel
authors.initials: JM
authors.lastname: Fabre
authors.affiliation: Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Pole des Pathologies Digestives, Hepatiques et de la Transplantation, Hopital de Hautepierre-Hopitaux Universitaires de Strasbourg, Université de Strasbourg, Strasbourg, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Bachellier
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000473:pathology / Q000601:surgery*; D018281:Cholangiocarcinoma / Q000473:pathology / Q000601:surgery*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis
keywords: Intrahepatic cholangiocarcinoma; Liver resection; Recurrent cholangiocarcinoma; Repeat hepatectomy; Risk factors for recurrence; Survival