TY - JOUR
T1 - Can hepatic resection provide a long-term cure for patients with intrahepatic cholangiocarcinoma?
AU - Spolverato, Gaya
AU - Vitale, Alessandro
AU - Cucchetti, Alessandro
AU - Popescu, Irinel
AU - Marques, Hugo P.
AU - Aldrighetti, Luca
AU - Gamblin, T. Clark
AU - Maithel, Shishir K.
AU - Sandroussi, Charbel
AU - Bauer, Todd W.
AU - Shen, Feng
AU - Poultsides, George A.
AU - Marsh, J. Wallis
AU - Pawlik, Timothy M.
PY - 2015/11/1
Y1 - 2015/11/1
N2 - 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
AB - 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
KW - cure
KW - hepatic resection
KW - intrahepatic cholangiocarcinoma
KW - surgery
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U2 - 10.1002/cncr.29619
DO - 10.1002/cncr.29619
M3 - Article
C2 - 26264223
AN - SCOPUS:84946491620
VL - 121
SP - 3998
EP - 4006
JO - Cancer
JF - Cancer
SN - 0008-543X
IS - 22
ER -