Abstract
Liver resection may represent the only hope of
cure for patients with intrahepatic cholangiocarcinoma
(IHC) but long-term results are still far from satisfactory
and the impact of prognostic factors is still controversial.
Fifty-five patients underwent hepatectomy for IHC between
1997 and 2008 in our unit. Features of the patients and the
tumors, operations, postoperative and long-term results
were retrospectively assessed. Twenty-one patients had
HBV/HCV infection, four had congenital biliary dilatation.
Thirty-two patients had increased CA 19-9; 12 had multiple
(C4) tumors. Operations included 43 major resections, with
9 resections of biliary confluence, 40 regional lymphadenectomies.
Operative mortality and morbidity were 0 and
27.3%, respectively. There were 44 R0-resections (80.0%).
Lymphadenectomy yielded lymph node metastases in 14
cases (14/40; 35.0%). Five-year overall and disease-free
survival rates were 30.2 and 27.5%, respectively. At multivariate
analysis the strongest poor prognostic factor for
overall survival was tumor stage. This factor, with multiplicity
of lesions (C4) and tumor grading[2, was significant
predictor of recurrence. CA19-9[100 IU/mL and
tumor grading[2 were found to be significantly related
with early multinodular hepatic recurrence. Patients with
lymph node metastases had significantly lower overall and
disease-free survival but patients who underwent lymph
node dissection with negative lymph nodes at final pathology
showed significantly higher 5-year disease-free survival
than patients who did not underwent lymphadenectomy.
In conclusion, these results support the role of hepatectomy
with regional lymphadenectomy as the best available
treatment for IHC. Prognosis after liver resection correlates
with clinical stage and multiplicity of lesions.
Lingua originale | English |
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pagine (da-a) | 11-19 |
Numero di pagine | 9 |
Rivista | Updates in Surgery |
Volume | 62 |
DOI | |
Stato di pubblicazione | Pubblicato - 2010 |
Keywords
- Epidemiology
- Intrahepatic cholangiocarcinoma
- Liver resection
- Prognostic factors
- Recurrence
- Reresection
- Survival