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Impact of Morphological Status on Long-Term Outcome Among Patients Undergoing Liver Surgery for Intrahepatic Cholangiocarcinoma

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

Abstract

Background

The influence of morphological status on the long-term outcome of patients undergoing liver resection for intrahepatic cholangiocarcinoma (ICC) is poorly defined. We sought to study the impact of morphological status on overall survival (OS) of patients undergoing curative-intent resection for ICC.

Methods

A total of 1083 patients who underwent liver resection for ICC between 1990 and 2015 were identified. Data on clinicopathological characteristics, operative details, and morphological status were recorded and analyzed. A propensity score-matched analysis was performed to reduce confounding biases.

Results

Among 1083 patients, 941(86.9%) had a mass-forming (MF) or intraductal-growth (IG) type, while 142 (13.1%) had a periductal-infiltrating (PI) or MF with PI components (MF + PI) ICC. Patients with an MF/IG ICC had a 5-year OS of 41.8% (95% confidence interval [CI] 37.7–45.9) compared with 25.5% (95% CI 17.3–34.4) for patients with a PI/MF + PI (p < 0.001). Morphological type was found to be an independent predictor of OS as patients with a PI/MF + PI ICC had a higher hazard of death (hazard ratio [HR] 1.42, 95% CI 1.11–1.82; p = 0.006) compared with patients who had an MF/IG ICC. Compared with T1a–T1b–T2 MF/IG tumors, T1a–T1b–T2 PI/MF + PI and T3–T4 PI/MF + PI tumors were associated with an increased risk of death (HR 1.47 vs. 3.59). Conversely, patients with T3–T4 MF/IG tumors had a similar risk of death compared with T1a–T1b–T2 MF/IG patients (p = 0.95).

Conclusion

Among patients undergoing curative-intent resection of ICC, morphological status was a predictor of long-term outcome. Patients with PI or MF + PI ICC had an approximately 45% increased risk of death long-term compared with patients who had an MF or IG ICC.

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Author notes

  1. Fabio Bagante and Gaya Spolverato contributed equally to this article.

Authors and Affiliations

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

    Fabio Bagante MD, Gaya Spolverato MD & Alfredo Guglielmi MD

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

    Matthew Weiss MD

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

    Sorin Alexandrescu MD

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

    Hugo P. Marques MD

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

    Luca Aldrighetti MD

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

    Shishir K. Maithel MD

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

    Carlo Pulitano MD

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

    Todd W. Bauer MD

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

    Feng Shen MD

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

    George A. Poultsides MD

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

    Oliver Soubrane MD

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

    Guillaume Martel MD

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

    B. Groot Koerkamp MD

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

    Endo Itaru MD

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

    Timothy M. Pawlik MD, MPH, PhD

  16. Department of Surgery, The Urban Meyer III and Shelley Meyer Chair in Cancer Research, The Ohio State University Wexner Medical Center, 395 W. 12th Avenue, Suite 670, Columbus, OH, 43210, USA

    Timothy M. Pawlik MD, MPH, PhD

Authors
  1. Fabio Bagante MD
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  2. Gaya Spolverato MD
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  3. Matthew Weiss MD
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  4. Sorin Alexandrescu MD
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  5. Hugo P. Marques MD
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  6. Luca Aldrighetti MD
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  7. Shishir K. Maithel MD
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  8. Carlo Pulitano MD
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  9. Todd W. Bauer MD
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  10. Feng Shen MD
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  11. George A. Poultsides MD
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  12. Oliver Soubrane MD
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  13. Guillaume Martel MD
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  14. B. Groot Koerkamp MD
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  15. Alfredo Guglielmi MD
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  16. Endo Itaru MD
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  17. Timothy M. Pawlik MD, MPH, PhD
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Corresponding author

Correspondence to Timothy M. Pawlik MD, MPH, PhD.

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Bagante, F., Spolverato, G., Weiss, M. et al. Impact of Morphological Status on Long-Term Outcome Among Patients Undergoing Liver Surgery for Intrahepatic Cholangiocarcinoma. Ann Surg Oncol 24, 2491–2501 (2017). https://doi.org/10.1245/s10434-017-5870-y

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  • DOI: https://doi.org/10.1245/s10434-017-5870-y

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