Intrahepatic cholangiocarcinoma: Primary liver resection and aggressive multimodal treatment of recurrence significantly prolong survival

Giorgio Ercolani, Gaetano Vetrone, Gian Luca Grazi, Osamu Aramaki, Matteo Cescon, Matteo Ravaioli, Carla Serra, Giovanni Brandi, Antonio Daniele Pinna

Research output: Contribution to journalArticle

Abstract

Objective: To evaluate the results of surgical therapy for intrahepatic cholangiocarcinoma (ICC), the incidence and the management of recurrence, and to analyze the change in approach during 2 different periods. DESIGN: Retrospective study. PATIENTS AND Methods: Patient and tumor characteristics, and overall and disease-free survival were analyzed in a series of 72 consecutive patients who underwent hepatic resection for ICC. Several factors likely to influence survival after resection were evaluated. Patients were divided into 2 groups according to the year of operation (before and after 1999). Management of recurrence and survival after recurrence were also analyzed. Results: The 3-and 5-year overall survival rates were 62% and 48%, whereas the 3-and 5-year disease-free survival rates were 30% and 25%, respectively. The median survival time was 57.1 months. Patient and histologic characteristics before and after 1999 were similar. Survival was significantly better among patients operated after 1999, who were node-negative, did not receive blood transfusion, and underwent adjuvant chemotherapy. The overall recurrence rates before and after 1999 were comparable (66.6% and 50%, P = 0.49). The most frequent site of recurrence was the liver. A significantly large number of patients received treatment for recurrence after 1999 (81.5%) compared with the first period (8.3%). The overall 3-year survival rate after recurrence was 46%. After 1999, there was a significant improvement in 3-year survival after recurrence (56%) compared with patients operated before 1999 (0%, P = 0.004); the median survival time from the diagnosis of recurrence increased from 20 months to 66 months in the second group. Conclusions: Although recurrence rate represents a frequent problem in ICC, an aggressive approach to recurrence can significantly prolong survival.

Original languageEnglish
Pages (from-to)107-114
Number of pages8
JournalAnnals of Surgery
Volume252
Issue number1
DOIs
Publication statusPublished - Jul 2010

ASJC Scopus subject areas

  • Surgery

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