Clinical Outcomes of Mass-Forming Intrahepatic Cholangiocarcinoma: A Case Series of 68 Patients

Abstract

1.1 Background: This study aims to examine the prognostic factors of patients with MF ICC in order to improve the outcomes of ICC. Methods:We carried out a retrospective analysis of consecutive patients with MF ICC treated at the Faculty of Hepato-Pancreato-Biliary Surgery of Chinese PLA General Hospital between January 2008 and December 2018. The patients were divided into the resection group and exploration group. Results:The 1-, 3-, and 5-year survival rates of the 68 cases in this study were 66.5%, 36.3%, and 9.3%, respectively. Univariate analyses revealed that the survival rates were significantly different according to nodal metastasis (P<0.001), vascular invasion (P<0.001), ascites (P<0.001), group (P<0.001), differentiation (P=0.009), and tumor location (P=0.032). Multivariate analysis demonstrated that ascites (HR=5.6, 95%CI: 1.6-18.9, P=0.006) and vascular invasion (HR=2.5, 95%CI: 1.0-6.1, P=0.045) were independent risk factors affecting the prognosis of the patients. Among patients who underwent surgical resection, the 1-, 3-, and 5-year survival rates of the 49 cases were 93.5%, 49.7%, and 14.4%, respectively. Univariate analyses showed that vascular invasion (P<0.001), nodal metastasis (P=0.001), and tumor size (P=0.044) were associated with survival. While vascular invasion (HR=3.1, 95% CI: 1.2-8.5, P=0.024) and nodal metastasis (HR=3.2, 95% CI: 1.4-7.6, P=0.008) were independently associated with survival. The 1-, 3-, and 5-year survival rates of the 19 cases in exploration group were 5.3%, 5.3%, and 0.0%, respectively. Conclusions:The prognosis of MF ICC was poor for patients with ascites or vascular invasion. Surgical resection is a key factor in improving survival. Vascular invasion and nodal metastasis affected the efficacy of surgical resection of MF ICC.