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Long-term outcome and prognostic factors of intrahepatic cholangiocarcinoma.
Chin Med J (Engl). 2009 Oct 05; 122(19):2286-91.CM

Abstract

BACKGROUND

The management of intrahepatic cholangiocarcinoma (ICC) remains a challenge due to poor prognosis. The aim of this study was to summarize the surgical management experience in recent 10 years and to identify the influencing factors related to outcome of patients with ICC in a single hepatobiliary center.

METHODS

From January 1995 to June 2005, 136 patients with ICC undergoing surgery were reviewed retrospectively. Survival rates of patients were calculated using the Kaplan-Meier method and compared by using the log-rank test. The prognostic factors were identified by the Cox regression model.

RESULTS

Seventy-nine of 136 patients underwent resection, and 65 of 79 patients were curative (R0). The surgical mortality was 2.2%. The 1-, 3- and 5-year survival rates of patients undergoing R0 resection were 72.1%, 35.6% and 20.1% respectively, which were significantly longer than those who underwent palliative resection and exploration, respectively (P < 0.01). At stage IV of the disease, 10 patients who underwent aggressive curative resection achieved a better median survival than those (n = 12) without resection (14 months vs 3 months, P < 0.001). The independent prognostic factors of the whole group were TNM stage (OR, 2.013, P = 0.008) and curative resection (OR, 2.957, P = 0.003). Higher TNM stage (OR, 1.894, P = 0.004) and lymph node metastasis (OR, 4.248, P = 0.005) linked to poor prognosis after R0 resection. For patients without lymph node metastasis, the median survival of those who underwent regional lymphadenectomy was comparable with those who did not (18 months vs 22 months, P = 0.817).

CONCLUSIONS

R0 resection is mandatory for ICC patient to achieve long-term survival. Aggressive resection benefits for selected patients with local advanced disease. Higher TNM stage and lymph node metastasis were poor prognostic factors for ICC patients after R0 resection.

Authors+Show Affiliations

Department of Hepatobiliary Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20079127

Citation

Li, Shao-qiang, et al. "Long-term Outcome and Prognostic Factors of Intrahepatic Cholangiocarcinoma." Chinese Medical Journal, vol. 122, no. 19, 2009, pp. 2286-91.
Li SQ, Liang LJ, Hua YP, et al. Long-term outcome and prognostic factors of intrahepatic cholangiocarcinoma. Chin Med J (Engl). 2009;122(19):2286-91.
Li, S. Q., Liang, L. J., Hua, Y. P., Peng, B. G., He, Q., Lu, M. D., & Chen, D. (2009). Long-term outcome and prognostic factors of intrahepatic cholangiocarcinoma. Chinese Medical Journal, 122(19), 2286-91.
Li SQ, et al. Long-term Outcome and Prognostic Factors of Intrahepatic Cholangiocarcinoma. Chin Med J (Engl). 2009 Oct 5;122(19):2286-91. PubMed PMID: 20079127.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term outcome and prognostic factors of intrahepatic cholangiocarcinoma. AU - Li,Shao-qiang, AU - Liang,Li-jian, AU - Hua,Yun-peng, AU - Peng,Bao-gang, AU - He,Qiang, AU - Lu,Ming-de, AU - Chen,Dong, PY - 2010/1/19/entrez PY - 2010/1/19/pubmed PY - 2010/3/18/medline SP - 2286 EP - 91 JF - Chinese medical journal JO - Chin Med J (Engl) VL - 122 IS - 19 N2 - BACKGROUND: The management of intrahepatic cholangiocarcinoma (ICC) remains a challenge due to poor prognosis. The aim of this study was to summarize the surgical management experience in recent 10 years and to identify the influencing factors related to outcome of patients with ICC in a single hepatobiliary center. METHODS: From January 1995 to June 2005, 136 patients with ICC undergoing surgery were reviewed retrospectively. Survival rates of patients were calculated using the Kaplan-Meier method and compared by using the log-rank test. The prognostic factors were identified by the Cox regression model. RESULTS: Seventy-nine of 136 patients underwent resection, and 65 of 79 patients were curative (R0). The surgical mortality was 2.2%. The 1-, 3- and 5-year survival rates of patients undergoing R0 resection were 72.1%, 35.6% and 20.1% respectively, which were significantly longer than those who underwent palliative resection and exploration, respectively (P < 0.01). At stage IV of the disease, 10 patients who underwent aggressive curative resection achieved a better median survival than those (n = 12) without resection (14 months vs 3 months, P < 0.001). The independent prognostic factors of the whole group were TNM stage (OR, 2.013, P = 0.008) and curative resection (OR, 2.957, P = 0.003). Higher TNM stage (OR, 1.894, P = 0.004) and lymph node metastasis (OR, 4.248, P = 0.005) linked to poor prognosis after R0 resection. For patients without lymph node metastasis, the median survival of those who underwent regional lymphadenectomy was comparable with those who did not (18 months vs 22 months, P = 0.817). CONCLUSIONS: R0 resection is mandatory for ICC patient to achieve long-term survival. Aggressive resection benefits for selected patients with local advanced disease. Higher TNM stage and lymph node metastasis were poor prognostic factors for ICC patients after R0 resection. SN - 2542-5641 UR - https://www.unboundmedicine.com/medline/citation/20079127/Long_term_outcome_and_prognostic_factors_of_intrahepatic_cholangiocarcinoma_ L2 - https://Insights.ovid.com/pubmed?pmid=20079127 DB - PRIME DP - Unbound Medicine ER -