Prognostic Factors for Intrahepatic Cholangiocarcinoma Treated with Surgical Resection

ABSTRACT

PURPOSE: Intrahepatic cholangiocarcinoma (ICC) is the second most common primary hepatic malignancy, but outcome studies are uncommon. The purpose of this study was to determine outcomes and prognostic factors after surgical resection. METHODS: We reviewed and analyzed retrospectively fifty four patients who were diagnosed as having intrahepatic cholangiocarcinoma and whose tumor was resected surgically between 2001 and 2009. Our analysis focused on survival and on significant prognostic factors affecting survival after surgical resection. RESULTS: Forty-one subjects (75.9%) were male and twelve (24.1%) were female. The average age was 59.4 years old. For predisposing factors, infestation of clonorchis sinensis plus hepatitis B antigen positivity were 11.1% respectively. Among tumor markers, CA 19-9 was elevated in 50.9% and CEA in 30%. Eighty percent were treated by major hepatectomy. Overall 3 & 5 year-survival rates were 41.8% and 36.2%, and 3 and 5 year disease free survival rates were 37.5% and 28.6%, respectively. By univariate analysis, significant prognostic factors affecting cumulative survival were tumor size, vascular invasion, tumor differentiation, serosal invasion, metastasis to the regional lymph nodes and tumor markers CEA and CA 19-9. By multivariate analysis, only differentiation and metastasis to the lymph nodes were significant. CONCLUSION: The prognosis of intrahepatic cholangiocarcinoma is poor but has been improved by curative surgical resection. Tumor factors, tumor differentiation and lymph node metastasis were elucidated as the most significant prognostic factors, and radical surgical resection is the only way to get a better outcome from IHC that has a notoriously poor prognosis.