Influencing factors for the prognosis of patients with early-stage intrahepatic cholangiocarcinoma after radical resection / 临床肝胆病杂志

ABSTRACT

ObjectiveTo investigate the influencing factors for the prognosis of patients with early-stage intrahepatic cholangiocarcinoma (ICC) after surgical treatment. MethodsA total of 155 patients with early-stage ICC who underwent radical resection in The Third Affiliated Hospital of Second Military Medical University from January 2013 to December 2014 were enrolled in this study. Clinicopathological features and 1-, 2-, and 3-year overall survival rates and disease-free survival rates after surgery were analyzed. The Cox forward stepwise regression was used for the univariate and multivariate analyses of the influencing factors for the prognosis of early-stage ICC. ResultsMost patients with early-stage ICC were middle-aged men, with an average tumor diameter of 5.8±2.5 cm. Most patients had normal liver function, but there were varying degrees of increase in carbohydrate antigen 19-9 (CA19-9) level. Postoperative pathological examination revealed highly or moderately differentiated adenocarcinoma in most patients. The 1-, 2-, and 3-year overall survival rates after surgery were 76.1%, 43.9%, and 34.1%, respectively, and the 1-, 2-, and 3-year disease-free survival rates were 50.3%, 250%, and 18.1%, respectively. The Cox multivariate analysis showed that high CA19-9 level before surgery (hazard ratio ［HR］=1705, 95% confidence interval ［CI］ 1.096-2.652, P=0.018), liver cirrhosis (HR=2.399, 95%CI 1.108-5.196, P=0.026), satellite nodules (HR=1.918, 95%CI 1.124-3.272, P=0.017), and degree of tumor cell differentiation (HR=5.568, 95%CI 2591-11.965, P＜0.0001) were independent risk factors for overall survival of patients early-stage ICC. Liver cirrhosis (HR=2.142, 95%CI 1.054-4.353, P=0.035), satellite nodules (HR=2.045, 95%CI 1.250-3.343, P=0.004), and degree of tumor cell differentiation (HR=2.748, 95%CI 1.340-5.638, P=0.006) were independent risk factors for disease-free survival of patients early-stage ICC. ConclusionRadical resection is the preferred treatment for patients with early-stage ICC. Preoperative CA19-9 ≥200 U/ml, liver cirrhosis, satellite nodules, and degree of tumor cell differentiation are independent risk factors for the prognosis of early-stage ICC.