BACKGROUND/AIMS: The present study was designed to provide a systematic analysis of prognosis of patients who underwent hepatic resection for intrahepatic cholangiocarcinoma (ICC). METHODOLOGY: Subjects were 36 consecutive ICC patients who had undergone hepatic resection between 1994 and 2005. The analyzed factors included various clinicopathological and surgical parameters, counts of microvessel stained for CD34 and expression of proliferative cell nuclear antigen. RESULTS: The 1, 2, 3-year disease-free survival rates after surgery were 33, 18, and 0% and the 1, 3 and 5-year overall survival rates were 45, 29, and 8%. High CEA levels (> or = 10 ng/mL), excessive intraoperative blood loss (> or = 1000 mL) and presence of neighboring peritoneal dissemination were significantly associated with shorter disease-free survival (p < 0.05). High CEA levels, periductal invasion type, excessive intraoperative blood loss and non-fibrotic liver were significant factors associated with shorter overall survival (p < 0.05). Multivariate Cox proportional hazards regression model identified high CEA values, periductal invasive type, excessive intraoperative blood loss and non-fibrotic liver as significant and independent determinants of poor prognosis. CONCLUSIONS: Hepatic resection with minimal blood loss followed by close follow-up is a suitable strategy for management of ICC patients with poor prognostic factors.
BACKGROUND/AIMS: The present study was designed to provide a systematic analysis of prognosis of patients who underwent hepatic resection for intrahepatic cholangiocarcinoma (ICC). METHODOLOGY: Subjects were 36 consecutive ICC patients who had undergone hepatic resection between 1994 and 2005. The analyzed factors included various clinicopathological and surgical parameters, counts of microvessel stained for CD34 and expression of proliferative cell nuclear antigen. RESULTS: The 1, 2, 3-year disease-free survival rates after surgery were 33, 18, and 0% and the 1, 3 and 5-year overall survival rates were 45, 29, and 8%. High CEA levels (> or = 10 ng/mL), excessive intraoperative blood loss (> or = 1000 mL) and presence of neighboring peritoneal dissemination were significantly associated with shorter disease-free survival (p < 0.05). High CEA levels, periductal invasion type, excessive intraoperative blood loss and non-fibrotic liver were significant factors associated with shorter overall survival (p < 0.05). Multivariate Cox proportional hazards regression model identified high CEA values, periductal invasive type, excessive intraoperative blood loss and non-fibrotic liver as significant and independent determinants of poor prognosis. CONCLUSIONS: Hepatic resection with minimal blood loss followed by close follow-up is a suitable strategy for management of ICC patients with poor prognostic factors.
Authors: Joshua G Barton; David A Barrett; Marco A Maricevich; Thomas Schnelldorfer; Christina M Wood; Thomas C Smyrk; Todd H Baron; Michael G Sarr; John H Donohue; Michael B Farnell; Michael L Kendrick; David M Nagorney; Kaye M Reid Lombardo; Florencia G Que Journal: HPB (Oxford) Date: 2009-12 Impact factor: 3.647