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Surgical Outcome and Prognostic Factors in Intrahepatic Cholangiocarcinoma

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Abstract

Background

The clinicopathologic features and surgical outcome of intrahepatic cholangiocarcinoma are not fully understood.

Methods

Fifty-six consecutive patients with intrahepatic cholangiocarcinoma who underwent surgical resection at the National Cancer Center Hospital East between October 1992 and July 2007 were retrospectively analyzed. Intrahepatic cholangiocarcinomas were subdivided into solitary tumors and tumors with intrahepatic metastasis.

Results

Complete tumor removal (R0 resection) was performed in 42 patients (75%). The 5-year survival rate for patients with intrahepatic cholangiocarcinoma (n = 56), patients with a solitary tumor (n = 46), and patients with intrahepatic metastasis (n = 10) were 32, 38, and 0%, respectively. There was a significant difference in survival between patients with a solitary tumor and those with intrahepatic metastasis (p < 0.0001). The 5-year survival rate for patients with stage I (n = 3), II (n = 9), III (n = 15), and IV disease (n = 26) was 100, 67, 37, and 0%, respectively. There was a significant difference in survival between stage I and stage IV (p = 0.011), between stage II and stage IV (p = 0.0002), and between stage III and stage IV (p = 0.0015). The most frequent site of recurrence was the liver. Univariate analysis showed that intrahepatic metastasis, portal vein invasion, hepatic duct invasion, lymph node metastasis, perineural invasion, and positive surgical margin (R1) were significantly associated with poor survival. Multivariate analysis confirmed that intrahepatic metastasis was a significant and independent prognostic indicator after surgical resection for intrahepatic cholangiocarcinoma (p = 0.001). No patient with intrahepatic metastasis survived more than 10 months in this study.

Conclusions

Intrahepatic metastasis was the strongest predictor of poor survival in intrahepatic cholangiocarcinoma.

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Authors and Affiliations

  1. Department of Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, 277-8577, Japan

    Toshio Nakagohri, Taira Kinoshita, Masaru Konishi, Shinichiro Takahashi & Naoto Gotohda

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  1. Toshio Nakagohri
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  2. Taira Kinoshita
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  3. Masaru Konishi
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  4. Shinichiro Takahashi
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  5. Naoto Gotohda
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Correspondence to Toshio Nakagohri.

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Nakagohri, T., Kinoshita, T., Konishi, M. et al. Surgical Outcome and Prognostic Factors in Intrahepatic Cholangiocarcinoma. World J Surg 32, 2675–2680 (2008). https://doi.org/10.1007/s00268-008-9778-3

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  • DOI: https://doi.org/10.1007/s00268-008-9778-3

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