Abstract
The aim of this study was to investigate the relationship between the clinicopathological characteristics of intrahepatic cholangiocarcinoma (ICC) and both disease-free survival (DFS) and overall survival (OS) in intrahepatic cholangiocarcinoma (ICC) patients who underwent radical resection (R0). We retrospectively analyzed the clinicopathological characteristics of 319 patients who underwent radical resection of ICC between October 1999 and December 2003. The independent adverse prognostic factors that affected DFS after radical resection of ICC were as follows: maximum tumor diameter (HR = 1.330, P = 0.014), complicated bile duct stone (HR = 1.923, P = 0.013), macroscopic tumor thrombus (HR = 1.826, P = 0.009), and lymph node metastasis (Pathology N1) (HR = 2.330, P = 0.005) were independent adverse prognostic factors that affected the DFS after radical resection of ICC. The postoperative median DFS was 6 months. The independent adverse prognostic factors that affected OS after radical resection of ICC were as follows: maximum tumor diameter (HR = 1.326, P = 0.014), complicated bile duct stone (HR = 2.349, P = 0.001), and lymph node metastasis (Pathology N1) (HR = 2.420, P = 0.003). The postoperative median survival time was 22 months, the 3-year survival rate was 33.9%, and the 5-year survival rate was 23.2%. Macroscopic tumor thrombus (OR = 2.991, P = 0.004) was an independent risk factor for death within 1 year after radical resection.
Highlights
Primary liver carcinoma (PLC) is the fifth most common malignant tumor, resulting in 600,000 deaths each year [1]
The univariate Cox analysis showed that the number of tumors, tumor distribution, perioperative blood transfusion, maximum tumor diameter, complicated bile duct stone, serum CA199 levels (U/ml), macroscopic tumor thrombus, Pathology T, Pathology N, and pathology stage were the prognostic factors that affected the disease-free survival (DFS) in patients who underwent radical hepatectomy for intrahepatic cholangiocarcinoma (ICC) (P < 0.05)
The significant prognostic factors determined by the univariate analysis were included in a multivariate Cox analysis, which showed that maximum tumor diameter (HR = 1.330, P = 0.014), complicated bile duct stone (HR = 1.923, P = 0.013), macroscopic tumor thrombus (HR = 1.826, P = 0.009), and Pathology N (HR = 2.330, P = 0.005) were independent adverse prognostic factors that affected the DFS of patients who underwent radical hepatectomy for ICC (Table 2)
Summary
Primary liver carcinoma (PLC) is the fifth most common malignant tumor, resulting in 600,000 deaths each year [1]. ICC is caused by a variety of etiologies, such as hepatitis B, hepatitis C, AIDS, intrahepatic bile duct stones, liver cirrhosis, primary sclerosing cholangitis, parasitic infections, chemical carcinogens, obesity, type II diabetes, and nonalcoholic fatty liver disease [10]. With the continuous improvement of the quality of life in China, the incidences of excessive alcohol consumption, obesity, type II diabetes, and nonalcoholic fatty liver disease have increased. The median survival time is only approximately 3 years, and the recurrence rate is as high as 50-60%; at the time of ICC diagnosis, the majority of patients are in the late stage and missed their opportunity to receive radical resection [16]. A high grade of malignancy, lower radical resection rate, and poor prognosis have resulted in a tremendous effect on ICC patients; this topic is worth further study
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