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Redefining Conditional Overall and Disease-Free Survival After Curative Resection for Intrahepatic Cholangiocarcinoma: a Multi-institutional, International Study of 1221 patients

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Objectives

To assess conditional survival (CS) according to recurrence status, as well as conditional disease-free survival (cDFS) among patients with intrahepatic cholangiocarcinoma (ICC).

Methods

CS and cDFS were evaluated among ICC patients who underwent curative-intent resection for ICC by using a multi-institutional database. Five-year CS (CS5) at “x” years was calculated separately for patients who did and did not experience recurrence. The cDFS3 at “x” years was defined as the chance to be disease-free for an additional 3 years after not having experienced a recurrence for “x” years postoperatively.

Results

Among 1221 patients, median OS was 36.8 months. While estimated actuarial OS decreased over time, CS5 increased as patients survived over longer periods of time and reached 93.9% at 4 years among 139 patients who did not experience a recurrence. Among the 725 (59.4%) patients who did experience a tumor recurrence, CS5 decreased to 17.7% the first postoperative year; however, CS5 subsequently increased to 79.7% for 81 patients who had survived 4 years after surgery. While actuarial DFS decreased from 54.6% at 1 year to 28.2% at 5 years, estimated cDFS3 following liver resection increased over time. Of note, patients with known risk factors for recurrence had even more marked improvements in cDFS3 over subsequent years versus patients without risk factors for recurrence.

Conclusion

CS and cDFS changed over time according to the presence of disease-specific risk factors, as well as the presence of recurrence.

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Funding

Liang-Shuo Hu and Xu-Feng Zhang were supported by the Clinical Research Award of the First Affiliated Hospital of Xi’an Jiaotong University of China (No. XJTU1AF-CRF-2017-004).

Author information

Author notes

  1. Liang-Shuo Hu and Xu-Feng Zhang contributed equally to this work.

Authors and Affiliations

  1. Department of Hepatobiliary Surgery and Institute of Advanced Surgical Technology and Engineering, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China

    Liang-Shuo Hu, Xu-Feng Zhang & Yi Lv

  2. Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA

    Xu-Feng Zhang & Timothy M. Pawlik

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

    Matthew Weiss

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

    Irinel Popescu

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

    Hugo P. Marques

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

    Luca Aldrighetti

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

    Shishir K. Maithel

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

    Carlo Pulitano

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

    Todd W. Bauer

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

    Feng Shen

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

    George A. Poultsides

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

    Oliver Soubrane

  13. Division of General Surgery, Department of Surgery, University of Ottawa, Ottawa, ON, Canada

    Guillaume Martel

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

    B. Groot Koerkamp

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

    Endo Itaru

  16. Department of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, Oncology, Health Services Management and Policy, The Ohio State University, Wexner Medical Center, 395 W. 12th Ave., Suite 670, Columbus, OH, USA

    Timothy M. Pawlik

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  1. Liang-Shuo Hu
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  2. Xu-Feng Zhang
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Correspondence to Timothy M. Pawlik.

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Hu, LS., Zhang, XF., Weiss, M. et al. Redefining Conditional Overall and Disease-Free Survival After Curative Resection for Intrahepatic Cholangiocarcinoma: a Multi-institutional, International Study of 1221 patients. J Gastrointest Surg 24, 2756–2765 (2020). https://doi.org/10.1007/s11605-019-04472-x

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  • DOI: https://doi.org/10.1007/s11605-019-04472-x

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