Surgical treatment of intrahepatic cholangiocarcinoma: a retrospective study of 104 cases

Abstract

Objective: To explore the clinicopathological features, surgical treatment techniques, and prognostic risk factors of intrahepatic cholangiocarcinoma (ICC).Methods: A total of 104 ICC cases were collected from January 2008 to December 2013 at Tianjin Medical University Cancer Institute and Hospital and divided into the hepatic hilum lymphadenectomy (HLL, 21 cases), extended hepatic hilum lymphadenectomy (EHLL, 12 cases), and non-lymphadenectomy (NL, 71 cases) groups. The clinical data of the patients were retrospectively analyzed, and the prognostic differences were compared among different groups.Results: The 1-, 2-, and 3-year overall survival (OS) rates of all cases were 72.1%, 56.1%, and 43.7%, respectively. The median survival duration was 34 months. The 1-, 2-, and 3-year OS rates of the HLL group (42.9%, 28.6%, and 28.6%, respectively) were significantly lower than those of the NL group (78.9%, 62.5%, and 47.8%, respectively). Meanwhile, the 1-, 2-, and 3-year OS rates of the EHLL group (75.0%, 56.1%, and 33.3%, respectively) were not significantly different from those of the other two groups. Univariate analysis showed that age, gender, American Joint Committee on Cancer (AJCC) stage, differentiation, ferritin (Fer), carbohydrate antigen19-9 (CA19-9) and carcinoembryonicantigen (CEA) levels, lymph node metastasis (LNM), and lymph node dissection (LND) were prognostic factors for the long-term survival of ICC. Meanwhile, multivariate analysis revealed that age, AJCC stage, differentiation, Fer levels, and LNM were independent risk factors for survival.Conclusions: ICC patients will not benefit from lymphadenectomy in the absence of LNM. However, systematic lymphadenectomy may improve ICC outcomes if the location of lymphatic metastasis is known. Age, AJCC stage, differentiation, Fer level, and LNM are independent risk factors for survival in ICC.

Prognostic Value of Inflammatory and Tumour Markers in Small-Duct Subtype Intrahepatic Cholangiocarcinoma after Curative-Intent Resection

“…Previous studies [ 29 , 30 ] showed that CA242 could improve the accuracy of ICC diagnosis. Meanwhile, only one literature from the authors' center [ 24 ] found that ferritin was an independent predictor of OS in ICC.…”

“…CEA is independent of serum bilirubin levels, and it may have a predictive value for surgical resection rates. Two studies reported that ferritin may serve as a risk factor for postoperative survival of patients with ICC [ 23 , 24 ].…”

Prognostic Value of International Normalized Ratio-to-Albumin Ratio and Ferritin Level in Chronic Liver Patients with Hepatocellular Carcinoma

“…AGR 0.5 after hepatectomy in HCC patients has been reported as an independent prognostic factor [33]. Intrahepatic cholangiocarcinoma (ICC) elevation of serum ferritin has been found to be associated with poor prognosis [37]. Vohra et al found that serum ferritin and transferrin ratio has been shown to be a prognostic biomarker in HCC patients [38].…”

Locoregional therapies in patients with recurrent intrahepatic cholangiocarcinoma after curative resection

“… 35 , 36 However, routine lymph node dissection did not improve long-term survival. 37 , 38 We did not perform routine lymph node dissection unless lymph node metastasis was suspected intraoperatively. Those with histologically proved lymph node metastases were excluded to simplify the initial tumor stage in this study.…”