The impact of surgical treatment and poor prognostic factors for patients with intrahepatic cholangiocarcinoma: retrospective analysis of 60 patients
Yo-ichi Yamashita, Akinobu Taketomi, Kazutoyo Morita, Takasuke Fukuhara, Shigeru Ueda, Kensaku Sanefuji, Tomohiro Iguchi, Hiroto Kayashima, Keishi Sugimachi, Yoshihiko Maehara, Yo-ichi Yamashita, Akinobu Taketomi, Kazutoyo Morita, Takasuke Fukuhara, Shigeru Ueda, Kensaku Sanefuji, Tomohiro Iguchi, Hiroto Kayashima, Keishi Sugimachi, Yoshihiko Maehara
Abstract
Background: Intrahepatic cholangiocarcinoma (ICC) is a primary adenocarcinoma of the liver arising from the intrahepatic bile duct. Hepatectomy with extensive lymph node dissection is the standard treatment for ICC.
Patients and methods: Sixty patients with ICC who underwent hepatectomy in our institution between 1986 and 2005 were investigated to determine prognostic factors and to evaluate the impact of surgical treatment for ICC using univariate and multivariate analyses.
Results: The overall survival rate of the R0 resection group (n=43) was significantly higher than that of the R1/2 group (n=17). However, in patients with lymph node metastasis (n=24), R0 resection had no survival impact. According to multivariate analysis, the independent factors of poor prognosis were: the presence of lymph node metastasis, lymphatic invasion, poor differentiation and R1/2 resection.
Conclusion: R0 resection can provide prolonged survival for patients with ICC. Patients with lymph node metastasis, lymphatic invasion, or poorly differentiated ICC have poor prognosis after operation and additional treatment, such as adjuvant chemotherapy, is recommended.
Source: PubMed