INTRODUCTION: Data on recurrence after operation for intrahepatic cholangiocarcinoma (ICC) are limited. We sought to investigate rates and patterns of recurrence in patients after operative intervention for ICC. METHODS: We identified 301 patients who underwent operation for ICC between 1990 and 2011 from an international, multi-institutional database. Clinicopathologic data, recurrence patterns, and recurrence-free survival (RFS) were analyzed. RESULTS: During the median follow up duration of 31 months (range 1-208), 53.5% developed a recurrence. Median RFS was 20.2 months and 5-year actuarial disease-free survival, 32.1%. The most common site for initial recurrence after operation of ICC was intrahepatic (n = 98; 60.9%), followed by simultaneous intra- and extrahepatic disease (n = 30; 18.6%); 33 (21.0%) patients developed extrahepatic recurrence only as the first site of recurrence. Macrovascular invasion (hazard ratio [HR], 2.08; 95% confidence interval [CI], 1.34-3.21; P < .001), nodal metastasis (HR, 1.55; 95% CI, 1.01-2.45; P = .04), unknown nodal status (HR, 1.57; 95% CI, 1.10-2.25; P = .04), and tumor size ≥ 5 cm (HR, 1.84; 95% CI, 1.28-2.65; P < .001) were independently associated with increased risk of recurrence. Patients were assigned a clinical score from 0 to 3 according to the presence of these risk factors. The 5-year RFS for patients with scores of 0, 1, 2, and 3 was 61.8%, 36.2%, 19.5%, and 9.6%, respectively. CONCLUSION: Recurrence after operative intervention for ICC was common. Disease recurred both at intra- and extrahepatic sites with roughly the same frequency. Factors such as lymph node metastasis, tumor size, and vascular invasion predict highest risk of recurrence.
INTRODUCTION: Data on recurrence after operation for intrahepatic cholangiocarcinoma (ICC) are limited. We sought to investigate rates and patterns of recurrence in patients after operative intervention for ICC. METHODS: We identified 301 patients who underwent operation for ICC between 1990 and 2011 from an international, multi-institutional database. Clinicopathologic data, recurrence patterns, and recurrence-free survival (RFS) were analyzed. RESULTS: During the median follow up duration of 31 months (range 1-208), 53.5% developed a recurrence. Median RFS was 20.2 months and 5-year actuarial disease-free survival, 32.1%. The most common site for initial recurrence after operation of ICC was intrahepatic (n = 98; 60.9%), followed by simultaneous intra- and extrahepatic disease (n = 30; 18.6%); 33 (21.0%) patients developed extrahepatic recurrence only as the first site of recurrence. Macrovascular invasion (hazard ratio [HR], 2.08; 95% confidence interval [CI], 1.34-3.21; P < .001), nodal metastasis (HR, 1.55; 95% CI, 1.01-2.45; P = .04), unknown nodal status (HR, 1.57; 95% CI, 1.10-2.25; P = .04), and tumor size ≥ 5 cm (HR, 1.84; 95% CI, 1.28-2.65; P < .001) were independently associated with increased risk of recurrence. Patients were assigned a clinical score from 0 to 3 according to the presence of these risk factors. The 5-year RFS for patients with scores of 0, 1, 2, and 3 was 61.8%, 36.2%, 19.5%, and 9.6%, respectively. CONCLUSION: Recurrence after operative intervention for ICC was common. Disease recurred both at intra- and extrahepatic sites with roughly the same frequency. Factors such as lymph node metastasis, tumor size, and vascular invasion predict highest risk of recurrence.
Authors: Mechteld C de Jong; Hari Nathan; Georgios C Sotiropoulos; Andreas Paul; Sorin Alexandrescu; Hugo Marques; Carlo Pulitano; Eduardo Barroso; Bryan M Clary; Luca Aldrighetti; Cristina R Ferrone; Andrew X Zhu; Todd W Bauer; Dustin M Walters; T Clark Gamblin; Kevin T Nguyen; Ryan Turley; Irinel Popescu; Catherine Hubert; Stephanie Meyer; Richard D Schulick; Michael A Choti; Jean-Francois Gigot; Gilles Mentha; Timothy M Pawlik Journal: J Clin Oncol Date: 2011-07-05 Impact factor: 44.544
Authors: Rafael A Ibarra; Daniel Rojas; Laura Snyder; Min Yao; Jeffrey Fabien; Michael Milano; Alan Katz; Karyn Goodman; Kevin Stephans; Galal El-Gazzaz; Federico Aucejo; Charles Miller; John Fung; Simon Lo; Mitchell Machtay; Juan R Sanabria Journal: Acta Oncol Date: 2012-01-23 Impact factor: 4.089
Authors: Gennaro Nuzzo; Felice Giuliante; Francesco Ardito; Agostino Maria De Rose; Maria Vellone; Gennaro Clemente; Carlo Chiarla; Ivo Giovannini Journal: Updates Surg Date: 2010-08
Authors: Ioannis Hatzaras; Carl Schmidt; Peter Muscarella; W Scott Melvin; E Christopher Ellison; Mark Bloomston Journal: HPB (Oxford) Date: 2010-03 Impact factor: 3.647
Authors: Xu-Feng Zhang; Eliza W Beal; Jeffery Chakedis; Qinyu Chen; Yi Lv; Cecilia G Ethun; Ahmed Salem; Sharon M Weber; Thuy Tran; George Poultsides; Andre Y Son; Ioannis Hatzaras; Linda Jin; Ryan C Fields; Stefan Buettner; Charles Scoggins; Robert C G Martin; Chelsea A Isom; Kamron Idrees; Harveshp D Mogal; Perry Shen; Shishir K Maithel; Carl R Schmidt; Timothy M Pawlik Journal: World J Surg Date: 2018-09 Impact factor: 3.352
Authors: Sean P Martin; Justin Drake; Michael M Wach; Samantha Ruff; Laurence P Diggs; Jim Y Wan; Zachary J Brown; Reed I Ayabe; Evan S Glazer; Paxton V Dickson; Jeremy L Davis; Jeremiah L Deneve; Jonathan M Hernandez Journal: Ann Surg Oncol Date: 2019-03-20 Impact factor: 5.344