Skip to main content
SpringerLink
Log in

Outcomes for Patients with Recurrent Intrahepatic Cholangiocarcinoma After Surgery

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

Abstract

Background

This study aimed to analyze the postoperative outcomes for patients with recurrent intrahepatic cholangiocarcinoma (ICC) and to determine the prognostic factors. In addition, this study investigated the effects of various treatment methods for patients with recurrent ICC.

Methods

This retrospective study analyzed the postoperative outcomes and prognostic factors of recurrent ICC that occurred for 81 of 128 patients who underwent hepatic resection for ICC between April 2001 and April 2013. In addition, the outcomes for a number of treatment methods were assessed for patients with recurrent ICC.

Results

After resection, the 128 patients with ICC had survival rates of 73 % at 1 year, 52 % at 3 years, and 43 % at 5 years. Recurrent ICC developed in 81 patients (56 men and 25 women) with a median age of 63 years. The median time from initial resection to recurrence was 9 months (range, 0–124 months), and the median survival time after recurrence was 8 months (range, 0–108 months). After recurrence, the overall survival rates were 47 % at 1 year, 23 % at 3 years, and 15 % at 5 years. Multivariate analysis showed disease-free survival time shorter than 1 year and bile duct invasion to be significant prognostic factors. Among the treatment methods, local management such as surgery, transarterial chemoembolization, and radiofrequency ablation were effective in select cases with localized intrahepatic and extrahepatic recurrence.

Conclusion

Active local treatment (i.e., surgery, transarterial chemoembolization [TACE], and radiofrequency ablation [RFA]) may improve survival for patients with localized ICC recurrence.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Patel T. Increasing incidence and mortality of primary intrahepatic cholangiocarcinoma in the United States. Hepatology. 2001;33:1353–7.

    Article  CAS  PubMed  Google Scholar 

  2. Cho SY, Park S-J, Kim SH, Han S-S, Kim Y-K, Lee K-W, et al. Survival analysis of intrahepatic cholangiocarcinoma after resection. Ann Surg Oncol. 2010;17:1823–30.

    Article  PubMed  Google Scholar 

  3. Endo I, Gonen M, Yopp AC, Dalal KM, Zhou Q, Klimstra D, et al. Intrahepatic cholangiocarcinoma: rising frequency, improved survival, and determinants of outcome after resection. Ann Surg. 2008;248:84–96.

    Article  PubMed  Google Scholar 

  4. Shimada K, Sano T, Sakamoto Y, Esaki M, Kosuge T, Ojima H. Surgical outcomes of the mass-forming plus periductal infiltrating types of intrahepatic cholangiocarcinoma: a comparative study with the typical mass-forming type of intrahepatic cholangiocarcinoma. World J Surg. 2007;31:2016–22.

    Article  PubMed  Google Scholar 

  5. Yamamoto M, Takasaki K, Otsubo T, Katsuragawa H, Katagiri S. Recurrence after surgical resection of intrahepatic cholangiocarcinoma. J Hepatobiliary Pancreat Surg. 2001;8:154–7.

    Article  CAS  PubMed  Google Scholar 

  6. Weber SM, Jarnagin WR, Klimstra D, DeMatteo RP, Fong Y, Blumgart LH. Intrahepatic cholangiocarcinoma: resectability, recurrence pattern, and outcomes. J Am Coll Surg. 2001;193:384–91.

    Article  CAS  PubMed  Google Scholar 

  7. Lang H, Sotiropoulos GC, Frühauf NR, Dömland M, Paul A, Kind EM, et al. Extended hepatectomy for intrahepatic cholangiocellular carcinoma (ICC): when is it worthwhile? Single-center experience with 27 resections in 50 patients over a 5-year period. Ann Surg. 2005;241:134–43.

    PubMed  PubMed Central  Google Scholar 

  8. Bridgewater J, Galle PR, Khan SA, Llovet JM, Park J-W, Patel T, et al. Guidelines for the diagnosis and management of intrahepatic cholangiocarcinoma. J Hepatol. 2014;60:1268–89.

    Article  PubMed  Google Scholar 

  9. Weimann A, Varnholt H, Schlitt HJ, Lang H, Flemming P, Hustedt C, et al. Retrospective analysis of prognostic factors after liver resection and transplantation for cholangiocellular carcinoma. Br J Surg. 2000;87:1182–7.

    Article  CAS  PubMed  Google Scholar 

  10. Inoue K, Makuuchi M, Takayama T, Torzilli G, Yamamoto J, Shimada K, et al. Long-term survival and prognostic factors in the surgical treatment of mass-forming type cholangiocarcinoma. Surgery. 2000;127:498–505.

    Article  CAS  PubMed  Google Scholar 

  11. Jan YY, Yeh CN, Yeh TS, Hwang TL, Chen MF. Clinicopathological factors predicting long-term overall survival after hepatectomy for peripheral cholangiocarcinoma. World J Surg. 2005;29:894–8.

    Article  PubMed  Google Scholar 

  12. Paik KY, Jung JC, Heo JS, Choi SH, Choi DW, Kim YI. What prognostic factors are important for resected intrahepatic cholangiocarcinoma? J Gastroenterol Hepatol. 2008;23:766–70.

    Article  PubMed  Google Scholar 

  13. Uenishi T, Kubo S, Yamazaki O, Yamada T, Sasaki Y, Nagano H, et al. Indications for surgical treatment of intrahepatic cholangiocarcinoma with lymph node metastases. J Hepatobiliary Pancreat Surg. 2008;15:417–22.

    Article  PubMed  Google Scholar 

  14. Tamandl D, Herberger B, Gruenberger B, Puhalla H, Klinger M, Gruenberger T. Influence of hepatic resection margin on recurrence and survival in intrahepatic cholangiocarcinoma. Ann Surg Oncol. 2008;15:2787–94.

    Article  PubMed  Google Scholar 

  15. Kawarada Y, Yamagiwa K, Das BC. Analysis of the relationships between clinicopathologic factors and survival time in intrahepatic cholangiocarcinoma. Am J Surg. 2002;183:679–85.

    Article  PubMed  Google Scholar 

  16. Okabayashi T, Yamamoto J, Kosuge T, Shimada K, Yamasaki S, Takayama T, et al. A new staging system for mass-forming intrahepatic cholangiocarcinoma: analysis of preoperative and postoperative variables. Cancer. 2001;92:2374–83.

    Article  CAS  PubMed  Google Scholar 

  17. Ohtsuka M, Ito H, Kimura F, Shimizu H, Togawa A, Yoshidome H, et al. Results of surgical treatment for intrahepatic cholangiocarcinoma and clinicopathological factors influencing survival. Br J Surg. 2002;89:1525–31.

    Article  CAS  PubMed  Google Scholar 

  18. DeOliveira ML, Cunningham SC, Cameron JL, Kamangar F, Winter JM, Lillemoe KD, et al. Cholangiocarcinoma: thirty-one-year experience with 564 patients at a single institution. Ann Surg. 2007;245:755–62.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Madariaga JR, Iwatsuki S, Todo S, Lee RG, Irish W, Starzl TE. Liver resection for hilar and peripheral cholangiocarcinoma: a study of 62 cases. Ann Surg. 1998;227:70–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Uenishi T, Hirohashi K, Kubo S, Yamamoto T, Hamba H, Tanaka H, et al. Histological factors affecting prognosis following hepatectomy for intrahepatic cholangiocarcinoma. World J Surg. 2001;25:865–9.

    Article  CAS  PubMed  Google Scholar 

  21. Khan SA, Davidson BR, Goldin R, Pereira SP, Rosenberg WM, Taylor-Robinson SD, et al. Guidelines for the diagnosis and treatment of cholangiocarcinoma: consensus document. Gut. 2002;51(Suppl 6):VI1–9.

  22. Saiura A, Yamamoto J, Kokudo N, Koga R, Seki M, Hiki N, et al. Intrahepatic cholangiocarcinoma: analysis of 44 consecutive resected cases including 5 cases with repeat resections. Am J Surg. 2011;201:203–8.

    Article  PubMed  Google Scholar 

  23. Ercolani G, Vetrone G, Grazi GL, Aramaki O, Cescon M, Ravaioli M, et al. Intrahepatic cholangiocarcinoma: primary liver resection and aggressive multimodal treatment of recurrence significantly prolong survival. Ann Surg. 2010;252:107–14.

    Article  PubMed  Google Scholar 

  24. Valverde A, Bonhomme N, Farges O, Sauvanet A, Flejou JF, Belghiti J. Resection of intrahepatic cholangiocarcinoma: a Western experience. J Hepatobiliary Pancreat Surg. 1999;6:122–7.

    Article  CAS  PubMed  Google Scholar 

  25. Choi SB, Kim KS, Choi JY, Park SW, Choi JS, Lee WJ, et al. The prognosis and survival outcome of intrahepatic cholangiocarcinoma following surgical resection: association of lymph node metastasis and lymph node dissection with survival. Ann Surg Oncol. 2009;16:3048–56.

    Article  PubMed  Google Scholar 

  26. Guglielmi A, Ruzzenente A, Campagnaro T, Pachera S, Valdegamberi A, Nicoli P, et al. Intrahepatic cholangiocarcinoma: prognostic factors after surgical resection. World J Surg. 2009 33:1247–54.

    Article  PubMed  Google Scholar 

  27. Kamphues C, Seehofer D, Eisele RM, Denecke T, Pratschke J, Neumann UP, et al. Recurrent intrahepatic cholangiocarcinoma: single-center experience using repeated hepatectomy and radiofrequency ablation. J Hepatobiliary Pancreat Sci. 2010;17:509–15.

    Article  PubMed  Google Scholar 

  28. Sulpice L, Rayar M, Boucher E, Pracht M, Meunier B, Boudjema K. Treatment of recurrent intrahepatic cholangiocarcinoma. Br J Surg. 2012;99:1711–7.

    Article  CAS  PubMed  Google Scholar 

  29. Jung DH, Kim M-S, Cho CK, Yoo HJ, Jang WI, Seo YS, et al. Outcomes of stereotactic body radiotherapy for unresectable primary or recurrent cholangiocarcinoma. Radiat Oncol J. 2014;32:163–9.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Fu Y, Yang W, Yan K, Xing B, Chen M. Radiofrequency ablation for postoperative recurrences of intrahepatic cholangiocarcinoma. Chin J Cancer Res. 2011;23:295–300.

    Article  PubMed  PubMed Central  Google Scholar 

  31. O’Suilleabhain CB, Poon RT, Lau CW, Fan ST. Repeated resections of extrahepatic metastases after hepatic resection: an aggressive approach to hepatocellular carcinoma. Hepatogastroenterology. 2004;51:825–9.

    PubMed  Google Scholar 

  32. Kaido T, Arii S, Shiota M, Imamura M. Repeated resection for extrahepatic recurrences after hepatectomy for ruptured hepatocellular carcinoma. J Hepatobiliary Pancreat Surg. 2004;11:149–52.

    Article  PubMed  Google Scholar 

  33. Hashimoto K, Miller CM. Liver transplantation for intrahepatic cholangiocarcinoma. J Hepatobiliary Pancreat Sci. 2015;22:138–43.

    Article  PubMed  Google Scholar 

  34. Sapisochín G, Fernández de Sevilla E, Echeverri J, Charco R. Liver transplantation for cholangiocarcinoma: current status and new insights. World J Hepatol. 2015;7:2396–403.

    Google Scholar 

Download references

Acknowledgments

The authors thank S. E. Lee and E. K. Hong for their valuable contribution to the data processing. They also thank S. M. Woo and W. J. Lee for their advice on the manuscript.

Disclosure

There are no conflicts of interest.

Author information

Author notes

    Authors and Affiliations

    1. Center for Liver Cancer, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea

      Hyeong Min Park MD, Eung Chang Lee MD, Seung Duk Lee MD, PhD, Sung-Sik Han MD, PhD, Seoung Hoon Kim MD, PhD & Sang-Jae Park MD, PhD

    2. Department of Surgery, Biomedical Research Institute, Pusan National University Hospital, Pusan, Republic of Korea

      Sung Pil Yun MD, PhD

    Authors
    1. Hyeong Min Park MD
      View author publications

      You can also search for this author in PubMed Google Scholar

    2. Sung Pil Yun MD, PhD
      View author publications

      You can also search for this author in PubMed Google Scholar

    3. Eung Chang Lee MD
      View author publications

      You can also search for this author in PubMed Google Scholar

    4. Seung Duk Lee MD, PhD
      View author publications

      You can also search for this author in PubMed Google Scholar

    5. Sung-Sik Han MD, PhD
      View author publications

      You can also search for this author in PubMed Google Scholar

    6. Seoung Hoon Kim MD, PhD
      View author publications

      You can also search for this author in PubMed Google Scholar

    7. Sang-Jae Park MD, PhD
      View author publications

      You can also search for this author in PubMed Google Scholar

    Corresponding author

    Correspondence to Sang-Jae Park MD, PhD.

    Additional information

    Hyeong Min Park and Sung Pil Yun have equally contributed to this work

    Rights and permissions

    Reprints and permissions

    About this article

    Check for updates. Verify currency and authenticity via CrossMark

    Cite this article

    Park, H.M., Yun, S.P., Lee, E.C. et al. Outcomes for Patients with Recurrent Intrahepatic Cholangiocarcinoma After Surgery. Ann Surg Oncol 23, 4392–4400 (2016). https://doi.org/10.1245/s10434-016-5454-2

    Download citation

    • Received:

    • Published:

    • Issue Date:

    • DOI: https://doi.org/10.1245/s10434-016-5454-2

    Keywords

    Search

    Navigation