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Surgical treatment for intrahepatic cholangiocarcinoma in Europe: a single center experience
Author(s) -
Bektas Hüseyin,
Yeyrek Cemil,
Kleine Moritz,
Vondran Florian W. R.,
Timrott Kai,
Schweitzer Nora,
Vogel Arndt,
Jäger Mark D.,
Schrem Harald,
Klempnauer Jürgen,
Kousoulas Lampros
Publication year - 2015
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1002/jhbp.158
Subject(s) - medicine , intrahepatic cholangiocarcinoma , hazard ratio , proportional hazards model , confidence interval , multivariate analysis , univariate analysis , survival analysis , hepatectomy , surgery , metastasis , retrospective cohort study , survival rate , gastroenterology , oncology , resection , cancer
Intrahepatic cholangiocarcinoma is the second most common primary liver tumor. The aim of this study was to analyze retrospectively the outcome of surgical treatment and prognostic factors. Clinical, histopathological and treatment data of 221 patients treated from 1995 to 2010 at our institution were investigated. Univariate and multivariate analysis of the patient's data was performed. Patients after R0 and R1 resection presented an overall survival of 67% and 54.5% after 1 year and 40% and 36.4% after 3 years, respectively. The survival of patients without resection of the tumor was dismal with 26% and 3.4% after 1 and 3 years, respectively. Survival after resection was not statistically different in cases with R0 versus R1 resection ( P = 0.639, log rank). Univariate Cox regression revealed that higher T stages are a significant hazard for survival ( P = 0.048, hazard ratio (HR): 1.211, 95% confidence interval (CI): 1.002–2.465). Patients with tumor recurrence had a significantly inferior long‐term survival when compared to patients without recurrence ( P < 0.001, log rank). Presence of lymph node metastasis ( N1 ) was an independent prognostic factor for survival after resection in risk‐adjusted multivariate Cox regression ( P < 0.001, HR: 2.577, 95% CI : 1.742–3.813). Adjuvant chemotherapy did not improve patient survival significantly ( P = 0.550, log rank). Surgical resection is still the best treatment option for intrahepatic cholangiocarcinoma regarding the patient's long‐term survival. R0 and R1 resection enable both better survival rates when compared to surgical exploration without resection. T status, N status, and tumor recurrence seem to be the most important prognostic factors after resection.