First and repeat liver resection for primary and recurrent intrahepatic cholangiocarcinoma

Am J Surg. 2016 Aug;212(2):221-9. doi: 10.1016/j.amjsurg.2015.07.016. Epub 2015 Oct 3.

Abstract

Background: Recurrence after resection of intrahepatic cholangiocarcinoma (ICC) remains common. The present study sought to evaluate risk factors for recurrence and the results of repeat liver resection (RLR) for recurrent ICC.

Methods: Between 1997 and 2012, clinical data and outcomes of 125 consecutive patients undergoing liver resection for ICC were retrospectively analyzed.

Results: The rate of R0 resection was 89% (n = 110). Overall median survival was 35 months, and 1-, 3-, and 5-year actuarial survival rates were 80%, 48%, and 28%, respectively. Recurrence occurred in 76 patients (63.5%) and was intrahepatic only for 39 patients (51%). Tumor size greater than 5 cm was identified as an independent risk factor for recurrence (P ≤ .0001). RLR for recurrent ICC was feasible in 10 patients (25%) with a median survival after recurrence of 25 months (16 to 76).

Conclusions: Tumor size more than 5 cm represents an independent risk factor for recurrence after resection of ICC. RLR in case of recurrent ICC, when feasible, is associated with longer overall survival.

Keywords: Intrahepatic cholangiocarcinoma; Liver resection; Recurrent cholangiocarcinoma; Repeat hepatectomy; Risk factors for recurrence; Survival.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bile Duct Neoplasms / pathology
  • Bile Duct Neoplasms / surgery*
  • Cholangiocarcinoma / pathology
  • Cholangiocarcinoma / surgery*
  • Female
  • Hepatectomy
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / surgery*
  • Reoperation
  • Retrospective Studies
  • Risk Factors
  • Survival Analysis