Can hepatic resection provide a long-term cure for patients with intrahepatic cholangiocarcinoma?

Gaya Spolverato, Alessandro Vitale, Alessandro Cucchetti, Irinel Popescu, Hugo P. Marques, Luca Aldrighetti, T. Clark Gamblin, Shishir K. Maithel, Charbel Sandroussi, Todd W. Bauer, Feng Shen, George A. Poultsides, J. Wallis Marsh, Timothy M. Pawlik

Research output: Contribution to journalArticle

49 Citations (Scopus)

Abstract

BACKGROUND A patient can be considered statistically cured from a specific disease when their mortality rate returns to the same level as that of the general population. In the current study, the authors sought to assess the probability of being statistically cured from intrahepatic cholangiocarcinoma (ICC) by hepatic resection. METHODS A total of 584 patients who underwent surgery with curative intent for ICC between 1990 and 2013 at 1 of 12 participating institutions were identified. A nonmixture cure model was adopted to compare mortality after hepatic resection with the mortality expected for the general population matched by sex and age. RESULTS The median, 1-year, 3-year, and 5-year disease-free survival was 10 months, 44%, 18%, and 11%, respectively; the corresponding overall survival was 27 months, 75%, 37%, and 22%, respectively. The probability of being cured of ICC was 9.7% (95% confidence interval, 6.1%-13.4%). The mortality of patients undergoing surgery for ICC was higher than that of the general population until year 10, at which time patients alive without tumor recurrence can be considered cured with 99% certainty. Multivariate analysis demonstrated that cure probabilities ranged from 25.8% (time to cure, 9.8 years) in patients with a single, well-differentiated ICC measuring ≤5 cm that was without vascular/periductal invasion and lymph nodes metastases versus

Original languageEnglish
Pages (from-to)3998-4006
Number of pages9
JournalCancer
Volume121
Issue number22
DOIs
Publication statusPublished - Nov 1 2015

Fingerprint

Cholangiocarcinoma
Liver
Mortality
Population
Disease-Free Survival
Blood Vessels
Multivariate Analysis
Lymph Nodes
Confidence Intervals
Neoplasm Metastasis
Recurrence
Survival
Neoplasms

Keywords

  • cure
  • hepatic resection
  • intrahepatic cholangiocarcinoma
  • surgery

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Spolverato, G., Vitale, A., Cucchetti, A., Popescu, I., Marques, H. P., Aldrighetti, L., ... Pawlik, T. M. (2015). Can hepatic resection provide a long-term cure for patients with intrahepatic cholangiocarcinoma? Cancer, 121(22), 3998-4006. https://doi.org/10.1002/cncr.29619

Can hepatic resection provide a long-term cure for patients with intrahepatic cholangiocarcinoma? / Spolverato, Gaya; Vitale, Alessandro; Cucchetti, Alessandro; Popescu, Irinel; Marques, Hugo P.; Aldrighetti, Luca; Gamblin, T. Clark; Maithel, Shishir K.; Sandroussi, Charbel; Bauer, Todd W.; Shen, Feng; Poultsides, George A.; Marsh, J. Wallis; Pawlik, Timothy M.

In: Cancer, Vol. 121, No. 22, 01.11.2015, p. 3998-4006.

Research output: Contribution to journalArticle

Spolverato, G, Vitale, A, Cucchetti, A, Popescu, I, Marques, HP, Aldrighetti, L, Gamblin, TC, Maithel, SK, Sandroussi, C, Bauer, TW, Shen, F, Poultsides, GA, Marsh, JW & Pawlik, TM 2015, 'Can hepatic resection provide a long-term cure for patients with intrahepatic cholangiocarcinoma?', Cancer, vol. 121, no. 22, pp. 3998-4006. https://doi.org/10.1002/cncr.29619
Spolverato, Gaya ; Vitale, Alessandro ; Cucchetti, Alessandro ; Popescu, Irinel ; Marques, Hugo P. ; Aldrighetti, Luca ; Gamblin, T. Clark ; Maithel, Shishir K. ; Sandroussi, Charbel ; Bauer, Todd W. ; Shen, Feng ; Poultsides, George A. ; Marsh, J. Wallis ; Pawlik, Timothy M. / Can hepatic resection provide a long-term cure for patients with intrahepatic cholangiocarcinoma?. In: Cancer. 2015 ; Vol. 121, No. 22. pp. 3998-4006.
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abstract = "BACKGROUND A patient can be considered statistically cured from a specific disease when their mortality rate returns to the same level as that of the general population. In the current study, the authors sought to assess the probability of being statistically cured from intrahepatic cholangiocarcinoma (ICC) by hepatic resection. METHODS A total of 584 patients who underwent surgery with curative intent for ICC between 1990 and 2013 at 1 of 12 participating institutions were identified. A nonmixture cure model was adopted to compare mortality after hepatic resection with the mortality expected for the general population matched by sex and age. RESULTS The median, 1-year, 3-year, and 5-year disease-free survival was 10 months, 44{\%}, 18{\%}, and 11{\%}, respectively; the corresponding overall survival was 27 months, 75{\%}, 37{\%}, and 22{\%}, respectively. The probability of being cured of ICC was 9.7{\%} (95{\%} confidence interval, 6.1{\%}-13.4{\%}). The mortality of patients undergoing surgery for ICC was higher than that of the general population until year 10, at which time patients alive without tumor recurrence can be considered cured with 99{\%} certainty. Multivariate analysis demonstrated that cure probabilities ranged from 25.8{\%} (time to cure, 9.8 years) in patients with a single, well-differentiated ICC measuring ≤5 cm that was without vascular/periductal invasion and lymph nodes metastases versus",
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