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Factors of Early Recurrence After Resection for Intrahepatic Cholangiocarcinoma

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Abstract

Background

Two-thirds of patients undergoing liver resection for intrahepatic cholangiocarcinoma experience recurrence after surgery. Our aim was to identify factors associated with early recurrence after resection for intrahepatic cholangiocarcinoma.

Methods

Patients with intrahepatic cholangiocarcinoma undergoing curative intent resection (complete resection and lymphadenectomy) were included in two centers between 2005 and 2021 and were divided into three groups: early recurrence (< 12 months after resection), delayed recurrence (> 12 months), and no recurrence. Patients experiencing early (< 90 days) postoperative mortality were excluded.

Results

Among 120 included patients, 44 (36.7%) experienced early recurrence, 24 (20.0%) experienced delayed recurrence, and 52 (43.3%) did not experience recurrence after a median follow-up of 59 months (IQR: 26-113). The median recurrence-free survival was 16 months (95% CI: 9.6–22.4). Median overall survival was 55 months (95% CI: 45.7–64.3), while it was 25 months for patients with early recurrence (p < 0.001). Patients with early recurrence had significantly larger tumors (59.1% of tumors > 70 mm in early vs. 58.3% in delayed vs. 26.9% in no recurrence group, p = 0.002), multiple lesions (65.9% vs. 29.2% vs. 11.5%, p < 0.001), and positive lymph nodes (N +) (38.6% vs. 37.5% vs. 11.5%, p = 0.005). In multivariable analysis, presence of multiple lesions (OR: 9.324; 95% CI: 3.051–28.489; p < 0.001) and positive lymph nodes (OR: 3.307. 95% CI: 1.001–11.011. p = 0.05) were associated with early recurrence.

Conclusion

Early recurrence after curative resection of intrahepatic cholangiocarcinoma is frequent and is associated with the presence of multiple lesions and positive lymph nodes, raising the question of surgery’s futility in this context.

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Funding

No funding was received for this study.

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Authors and Affiliations

  1. Department of Hepatobiliary, Pancreatic and Endocrine Surgery, Cochin Hospital, Assistance publique-hôpitaux de Paris, University of Paris, 27 rue du Faubourg Saint-Jacques, 75014, Paris, France

    Alexandra Nassar, Stylianos Tzedakis, Rémy Sindayigaya, Ugo Marchese, Julie Veziant, Alix Dhote, Marie Strigalev & David Fuks

  2. Department of Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Beaujon Hospital, Assistance publique-hôpitaux de Paris, University of Paris, Clichy, France

    Christian Hobeika, Tatiana Codjia & François Cauchy

  3. Department of Pathology, Beaujon Hospital, Assistance publique-hôpitaux de Paris, University of Paris, Clichy, France

    Aurélie Beaufrère

Authors
  1. Alexandra Nassar
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  2. Stylianos Tzedakis
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  3. Rémy Sindayigaya
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  4. Christian Hobeika
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  10. Marie Strigalev
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  11. François Cauchy
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Contributions

AN, ST, RS, DF contributed to conception and design. ST, RS, UM, DF provided administrative support. UM, JV, FC, DF contributed to provision of study materials or patients. AN, CH, TC, AB, AD, MS contributed to collection and assembly of data. AN, ST, RS, FC, DF contributed to data analysis and interpretation. All authors contributed to manuscript writing. All authors approved the final version of manuscript.

Corresponding author

Correspondence to Alexandra Nassar.

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This study has not been previously published elsewhere. All authors actively contributed to this work and gave their final approval before submission.

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Nassar, A., Tzedakis, S., Sindayigaya, R. et al. Factors of Early Recurrence After Resection for Intrahepatic Cholangiocarcinoma. World J Surg 46, 2459–2467 (2022). https://doi.org/10.1007/s00268-022-06655-1

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  • DOI: https://doi.org/10.1007/s00268-022-06655-1

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