Analysis of 50 Consecutive Hepatic Resection Cases for Intrahepatic Cholangiocarcinoma

ABSTRACT

PURPOSE: Intrahepatic cholangiocarcinoma (CCC) is the second most common primary liver cancer and constitutes 10% of primary liver malignancies. The prognosis of hepatic resection for CCC and the specific factors influencing survival remain unclear. The aims of this study were to analyze the survival outcome and the prognostic factors in patients with CCC who underwent hepatic resection and suggest relevant prognostic factors. METHODS: Between April 2001 and February 2006, 50 patients with CCC underwent hepatic resection. Patients with hilar cholangiocarcinoma and gallbladder carcinoma were excluded. All patients were considered resectable based on dynamic CT or MRI findings. Patients with R1 resection or nodal invasion received adjuvant chemotherapy or radiation. Twenty-four clinicopathological factors were divided into three into categories and analyzed to evaluate their influence on the outcomes. RESULTS: There were 2 operative death (mortality; 4%). Postoperative complications occurred in 12 of the 50 (24%) patients. The 1-, 2- and 3-year overall survival rates were 69.8%, 53.6% and 46.9% respectively. The following variables were significant prognostic factors in univariate analysis. Age, presence of hepatitis or liver cirrhosis in patient-related factors, lymph node metastasis, TNM stage according to 6th AJCC in tumor-related factors and intraoperative transfusion in treatment-related factors. Multivariate analysis identified only lymph node metastasis is an independent prognostic factor for poor prognosis. CONCLUSION: Hepatic resection remains the most effective therapeutic option for CCC. Lymph node metastasis was the single worst prognostic factor for CCC resection. Further study for the benefit of resection for the lymph node positive CCC is needed.