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Application of Hazard Function to Investigate Recurrence of Intrahepatic Cholangiocarcinoma After Curative-Intent Liver Resection: A Novel Approach to Characterize Recurrence

  • Hepatobiliary Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Purpose

To investigate recurrence patterns after surgery for intrahepatic cholangiocarcinoma (ICC) relative to lymph node status, tumor extension, tumor burden score (TBS), and adjuvant chemotherapy.

Methods

Patients who underwent curative-intent resection for ICC from 1990 to 2020 were enrolled from a multi-institutional database. The hazard function was applied to plot the hazard rates over time, with further stratification by T and N AJCC 8th edition categories, TBS, and adjuvant chemotherapy.

Results

A total of 1192 patients underwent curative-intent resection for ICC and 59.9% experienced recurrence. Overall, the peak of recurrence occurred at 6.6 months. Among patients with negative lymph nodes, the T4-category had a higher peak rate of recurrence (0.1199 at 10.2 months) compared with other T-categories, while high TBS had an earlier peak of recurrence (4.2 months) compared with lower TBS. Among patients with N1 disease, T2–T4 categories had multipeak patterns of recurrence with higher hazard rates during the first 3 years after surgery in comparison with T1-category, while patients with high TBS had an earlier (4.0 months) and higher hazard peak rate compared with lower TBS groups. The administration of adjuvant chemotherapy was associated with delayed hazard rates of recurrence for N1 (4 months) and NX (6 months) categories.

Discussion

The novel application of the hazard function to assess hazard rates and timing patterns of recurrence following resection for ICC demonstrated that recurrence varied based on T- and N-categories, as well as TBS. Hazard function-based recurrence data may be helpful to tailor counseling, surveillance, and adjuvant therapy recommendations.

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Author information

Authors and Affiliations

  1. Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA

    Laura Alaimo MD, Zorays Moazzam MD, Zachary J. Brown DO, Yutaka Endo MD, PhD & Timothy M. Pawlik MD, PhD, MPH, MTS, MBA, FACS, FRACS (Hon.)

  2. Department of Surgery, University of Verona, Verona, Italy

    Laura Alaimo MD, Andrea Ruzzenente MD, PhD & Alfredo Guglielmi MD

  3. Department of Surgery, Ospedale San Raffaele, Milan, Italy

    Luca Aldrighetti MD

  4. Department of Surgery, Johns Hopkins Hospital, Baltimore, MD, USA

    Matthew Weiss MD

  5. Department of Surgery, University of Virginia, Charlottesville, VA, USA

    Todd W. Bauer MD

  6. Department of Surgery, Fundeni Clinical Institute, Bucharest, Romania

    Sorin Alexandrescu MD

  7. Department of Surgery, Stanford University, Stanford, CA, USA

    George A. Poultsides MD

  8. Department of Surgery, Emory University, Atlanta, GA, USA

    Shishir K. Maithel MD

  9. Department of Surgery, Curry Cabral Hospital, Lisbon, Portugal

    Hugo P. Marques MD

  10. Department of Surgery, University of Ottawa, Ottawa, ON, Canada

    Guillaume Martel MD

  11. Department of Surgery, Royal Prince Alfred Hospital, University of Sydney, Sydney, NSW, Australia

    Carlo Pulitano MD

  12. Department of Surgery, Eastern Hepatobiliary Surgery Hospital, Shanghai, China

    Feng Shen MD

  13. Department of Hepatobiliopancreatic Surgery and Liver Transplantation, AP-HP, Beaujon Hospital, Clichy, France

    Olivier Soubrane MD

  14. Department of Surgery, Erasmus University Medical Centre, Rotterdam, The Netherlands

    Bas Groot Koerkamp MD

  15. Department of Gastroenterological Surgery, Yokohama City University School of Medicine, Yokohama, Japan

    Itaru Endo MD, PhD

  16. Department of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, The Ohio State University Wexner Medical Center, Columbus, OH, USA

    Timothy M. Pawlik MD, PhD, MPH, MTS, MBA, FACS, FRACS (Hon.)

Authors
  1. Laura Alaimo MD
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  2. Zorays Moazzam MD
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  3. Zachary J. Brown DO
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  6. Alfredo Guglielmi MD
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  7. Luca Aldrighetti MD
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  12. Shishir K. Maithel MD
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  14. Guillaume Martel MD
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  16. Feng Shen MD
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  17. Olivier Soubrane MD
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  18. Bas Groot Koerkamp MD
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  19. Itaru Endo MD, PhD
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  20. Timothy M. Pawlik MD, PhD, MPH, MTS, MBA, FACS, FRACS (Hon.)
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Corresponding author

Correspondence to Timothy M. Pawlik MD, PhD, MPH, MTS, MBA, FACS, FRACS (Hon.).

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Alaimo, L., Moazzam, Z., Brown, Z.J. et al. Application of Hazard Function to Investigate Recurrence of Intrahepatic Cholangiocarcinoma After Curative-Intent Liver Resection: A Novel Approach to Characterize Recurrence. Ann Surg Oncol 30, 1340–1349 (2023). https://doi.org/10.1245/s10434-022-12463-7

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  • DOI: https://doi.org/10.1245/s10434-022-12463-7

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