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Published in: BMC Gastroenterology 1/2018

Open Access 01-12-2018 | Research article

Characterization of intrahepatic cholangiocarcinoma after curative resection: outcome, prognostic factor, and recurrence

Authors: Kun-Ming Chan, Chun-Yi Tsai, Chun-Nan Yeh, Ta-Sen Yeh, Wei-Chen Lee, Yi-Yin Jan, Miin-Fu Chen

Published in: BMC Gastroenterology | Issue 1/2018

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Abstract

Background

Intrahepatic cholangiocarcinoma (ICC) is a relatively rare subtype of cholangiocarcinoma. The study herein gathered experience of surgical treatment for ICC, and aimed to analyze the prognosis of patients who had received curative-intent liver resection.

Methods

A total of 216 patients who had undergone curative-intent liver resection for ICC between January 1977 and December 2014 was retrospectively reviewed.

Results

Overall, the rates of 5-years recurrence-free survival (RFS) and overall survival (OS) were 26.1 and 33.9% respectively. Based on multivariate analysis, four independent adverse prognostic factors including morphology patterns, maximum tumor size > 5 cm, pathological lymph node involvement, and vascular invasion were identified as affecting RFS after curative-intent liver resection for ICC. Among patients with cholangiocarcinoma recurrence, only 27 (16.9%) were able to receive surgical resection for recurrent cholangiocarcinoma that had a significantly better outcome than the remaining patients.

Conclusion

Despite curative resection, the general outcome of patients with ICC is still unsatisfactory because of a high incidence of cholangiocarcinoma recurrence after operation. Tumor factors associated with cholangiocarcinoma remain crucial for the prognosis of patients with ICC after curative liver resection. Moreover, aggressive attitude toward repeat resection for the postoperative recurrent cholangiocarcinoma could provide a favorable outcome for patients.
Literature
1.
go back to reference Chen MF. Peripheral cholangiocarcinoma (cholangiocellular carcinoma): clinical features, diagnosis and treatment. J Gastroenterol Hepatol. 1999;14:1144–9.CrossRefPubMed Chen MF. Peripheral cholangiocarcinoma (cholangiocellular carcinoma): clinical features, diagnosis and treatment. J Gastroenterol Hepatol. 1999;14:1144–9.CrossRefPubMed
3.
4.
go back to reference Jan YY, Yeh CN, Yeh TS, Hwang TL, Chen MF. Clinicopathological factors predicting long-term overall survival after hepatectomy for peripheral cholangiocarcinoma. World J Surg. 2005;29:894–8.CrossRefPubMed Jan YY, Yeh CN, Yeh TS, Hwang TL, Chen MF. Clinicopathological factors predicting long-term overall survival after hepatectomy for peripheral cholangiocarcinoma. World J Surg. 2005;29:894–8.CrossRefPubMed
5.
go back to reference Patel T. Increasing incidence and mortality of primary intrahepatic cholangiocarcinoma in the United States. Hepatology. 2001;33:1353–7.CrossRefPubMed Patel T. Increasing incidence and mortality of primary intrahepatic cholangiocarcinoma in the United States. Hepatology. 2001;33:1353–7.CrossRefPubMed
6.
go back to reference Moeini A, Sia D, Bardeesy N, Mazzaferro V, Llovet JM. Molecular pathogenesis and targeted therapies for intrahepatic Cholangiocarcinoma. Clin Cancer Res. 2016;22:291–300.CrossRefPubMed Moeini A, Sia D, Bardeesy N, Mazzaferro V, Llovet JM. Molecular pathogenesis and targeted therapies for intrahepatic Cholangiocarcinoma. Clin Cancer Res. 2016;22:291–300.CrossRefPubMed
7.
go back to reference de Jong MC, Nathan H, Sotiropoulos GC, Paul A, Alexandrescu S, Marques H, Pulitano C, et al. Intrahepatic cholangiocarcinoma: an international multi-institutional analysis of prognostic factors and lymph node assessment. J Clin Oncol. 2011;29:3140–5.CrossRefPubMed de Jong MC, Nathan H, Sotiropoulos GC, Paul A, Alexandrescu S, Marques H, Pulitano C, et al. Intrahepatic cholangiocarcinoma: an international multi-institutional analysis of prognostic factors and lymph node assessment. J Clin Oncol. 2011;29:3140–5.CrossRefPubMed
8.
go back to reference DeOliveira ML, Cunningham SC, Cameron JL, Kamangar F, Winter JM, Lillemoe KD, Choti MA, et al. Cholangiocarcinoma: thirty-one-year experience with 564 patients at a single institution. Ann Surg. 2007;245:755–62.CrossRefPubMedPubMedCentral DeOliveira ML, Cunningham SC, Cameron JL, Kamangar F, Winter JM, Lillemoe KD, Choti MA, et al. Cholangiocarcinoma: thirty-one-year experience with 564 patients at a single institution. Ann Surg. 2007;245:755–62.CrossRefPubMedPubMedCentral
9.
go back to reference El-Serag HB, Engels EA, Landgren O, Chiao E, Henderson L, Amaratunge HC, Giordano TP. Risk of hepatobiliary and pancreatic cancers after hepatitis C virus infection: a population-based study of U.S. veterans. Hepatology. 2009;49:116–23.CrossRefPubMedPubMedCentral El-Serag HB, Engels EA, Landgren O, Chiao E, Henderson L, Amaratunge HC, Giordano TP. Risk of hepatobiliary and pancreatic cancers after hepatitis C virus infection: a population-based study of U.S. veterans. Hepatology. 2009;49:116–23.CrossRefPubMedPubMedCentral
10.
go back to reference Lee TY, Lee SS, Jung SW, Jeon SH, Yun SC, Oh HC, Kwon S, et al. Hepatitis B virus infection and intrahepatic cholangiocarcinoma in Korea: a case-control study. Am J Gastroenterol. 2008;103:1716–20.CrossRefPubMed Lee TY, Lee SS, Jung SW, Jeon SH, Yun SC, Oh HC, Kwon S, et al. Hepatitis B virus infection and intrahepatic cholangiocarcinoma in Korea: a case-control study. Am J Gastroenterol. 2008;103:1716–20.CrossRefPubMed
11.
go back to reference Welzel TM, Mellemkjaer L, Gloria G, Sakoda LC, Hsing AW, El Ghormli L, Olsen JH, et al. Risk factors for intrahepatic cholangiocarcinoma in a low-risk population: a nationwide case-control study. Int J Cancer. 2007;120:638–41.CrossRefPubMed Welzel TM, Mellemkjaer L, Gloria G, Sakoda LC, Hsing AW, El Ghormli L, Olsen JH, et al. Risk factors for intrahepatic cholangiocarcinoma in a low-risk population: a nationwide case-control study. Int J Cancer. 2007;120:638–41.CrossRefPubMed
12.
go back to reference Zhou YM, Yin ZF, Yang JM, Li B, Shao WY, Xu F, Wang YL, et al. Risk factors for intrahepatic cholangiocarcinoma: a case-control study in China. World J Gastroenterol. 2008;14:632–5.CrossRefPubMedPubMedCentral Zhou YM, Yin ZF, Yang JM, Li B, Shao WY, Xu F, Wang YL, et al. Risk factors for intrahepatic cholangiocarcinoma: a case-control study in China. World J Gastroenterol. 2008;14:632–5.CrossRefPubMedPubMedCentral
13.
go back to reference Chapman MH, Webster GJ, Bannoo S, Johnson GJ, Wittmann J, Pereira SP. Cholangiocarcinoma and dominant strictures in patients with primary sclerosing cholangitis: a 25-year single-centre experience. Eur J Gastroenterol Hepatol. 2012;24:1051–8.CrossRefPubMedPubMedCentral Chapman MH, Webster GJ, Bannoo S, Johnson GJ, Wittmann J, Pereira SP. Cholangiocarcinoma and dominant strictures in patients with primary sclerosing cholangitis: a 25-year single-centre experience. Eur J Gastroenterol Hepatol. 2012;24:1051–8.CrossRefPubMedPubMedCentral
14.
go back to reference Huang MH, Chen CH, Yen CM, Yang JC, Yang CC, Yeh YH, Chou DA, et al. Relation of hepatolithiasis to helminthic infestation. J Gastroenterol Hepatol. 2005;20:141–6.CrossRefPubMed Huang MH, Chen CH, Yen CM, Yang JC, Yang CC, Yeh YH, Chou DA, et al. Relation of hepatolithiasis to helminthic infestation. J Gastroenterol Hepatol. 2005;20:141–6.CrossRefPubMed
15.
go back to reference Jiang W, Zeng ZC, Tang ZY, Fan J, Sun HC, Zhou J, Zeng MS, et al. A prognostic scoring system based on clinical features of intrahepatic cholangiocarcinoma: the Fudan score. Ann Oncol. 2011;22:1644–52.CrossRefPubMed Jiang W, Zeng ZC, Tang ZY, Fan J, Sun HC, Zhou J, Zeng MS, et al. A prognostic scoring system based on clinical features of intrahepatic cholangiocarcinoma: the Fudan score. Ann Oncol. 2011;22:1644–52.CrossRefPubMed
16.
go back to reference Ribero D, Pinna AD, Guglielmi A, Ponti A, Nuzzo G, Giulini SM, Aldrighetti L, et al. Surgical approach for long-term survival of patients with intrahepatic Cholangiocarcinoma: a multi-institutional analysis of 434 patients. Arch Surg. 2012;147:1107–13.CrossRefPubMed Ribero D, Pinna AD, Guglielmi A, Ponti A, Nuzzo G, Giulini SM, Aldrighetti L, et al. Surgical approach for long-term survival of patients with intrahepatic Cholangiocarcinoma: a multi-institutional analysis of 434 patients. Arch Surg. 2012;147:1107–13.CrossRefPubMed
17.
go back to reference Wang Y, Li J, Xia Y, Gong R, Wang K, Yan Z, Wan X, et al. Prognostic nomogram for intrahepatic cholangiocarcinoma after partial hepatectomy. J Clin Oncol. 2013;31:1188–95.CrossRefPubMed Wang Y, Li J, Xia Y, Gong R, Wang K, Yan Z, Wan X, et al. Prognostic nomogram for intrahepatic cholangiocarcinoma after partial hepatectomy. J Clin Oncol. 2013;31:1188–95.CrossRefPubMed
18.
go back to reference Ni Q, Shen W, Zhang M, Yang C, Cai W, Wu M, Yang J. Prognostic analysis of radical resection for intrahepatic cholangiocarcinoma: a retrospective cohort study. Oncotarget. 2017;8(43):75627-37. Ni Q, Shen W, Zhang M, Yang C, Cai W, Wu M, Yang J. Prognostic analysis of radical resection for intrahepatic cholangiocarcinoma: a retrospective cohort study. Oncotarget. 2017;8(43):75627-37.
19.
go back to reference Amini N, Ejaz A, Spolverato G, Maithel SK, Kim Y, Pawlik TM. Management of lymph nodes during resection of hepatocellular carcinoma and intrahepatic cholangiocarcinoma: a systematic review. J Gastrointest Surg. 2014;18:2136–48.CrossRefPubMed Amini N, Ejaz A, Spolverato G, Maithel SK, Kim Y, Pawlik TM. Management of lymph nodes during resection of hepatocellular carcinoma and intrahepatic cholangiocarcinoma: a systematic review. J Gastrointest Surg. 2014;18:2136–48.CrossRefPubMed
20.
go back to reference Chan KM, Chou HS, Wu TJ, Lee CF, Yu MC, Lee WC. Characterization of hepatocellular carcinoma recurrence after liver transplantation: perioperative prognostic factors, patterns, and outcome. Asian J Surg. 2011;34:128–34.CrossRefPubMed Chan KM, Chou HS, Wu TJ, Lee CF, Yu MC, Lee WC. Characterization of hepatocellular carcinoma recurrence after liver transplantation: perioperative prognostic factors, patterns, and outcome. Asian J Surg. 2011;34:128–34.CrossRefPubMed
21.
go back to reference Lee WC, Jeng LB, Chen MF. Estimation of prognosis after hepatectomy for hepatocellular carcinoma. Br J Surg. 2002;89:311–6.CrossRefPubMed Lee WC, Jeng LB, Chen MF. Estimation of prognosis after hepatectomy for hepatocellular carcinoma. Br J Surg. 2002;89:311–6.CrossRefPubMed
Metadata
Title
Characterization of intrahepatic cholangiocarcinoma after curative resection: outcome, prognostic factor, and recurrence
Authors
Kun-Ming Chan
Chun-Yi Tsai
Chun-Nan Yeh
Ta-Sen Yeh
Wei-Chen Lee
Yi-Yin Jan
Miin-Fu Chen
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Gastroenterology / Issue 1/2018
Electronic ISSN: 1471-230X
DOI
https://doi.org/10.1186/s12876-018-0912-x

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