Retrospective Analysis of Prognostic Factors after Liver Transplantation for Intrahepatic Cholangiocarcinoma in China: A Single-Center Experience

Abstract

This study aims to assess the prognosis of liver transplantation for ICC patients and try to identify prognostic factors that could influence survival for intrahepatic cholangiocarcinoma patients treated by liver transplantation. Between February 1999 and February 2010, 20 patients with ICC underwent liver transplantation. The Kaplan-Meier method was used to calculate the actuarial survival rate and tumor-free survival rate. Log-rank test was used to compare the differences between groups. Univariate Cox proportional hazard regression model was used to analyze each factor that might have influenced liver transplantation prognosis in ICC patients and to identify factors with statistical significance. Actuarial survival rate at 1, 2, 3 and 5 years achieved 84.2%, 43.7%, 32.7% and 21.8%, respectively. Tumor-free survival at 1, 2, 3 and 5 years was 55.6%, 43.2%, 28.8% and 18.8%, respectively. In univariate analysis, lobar distribution, multiple tumors, lymph node invasion, macrovascular invasion, advanced pTNM classification stages, neoadjuvant therapy and differentiation were associated significantly with survival, especially the former 6 factors. In multivariate analysis, lymph node invasion, macrovascular invasion and multiple tumors were the independent predictors of survival, especially lymph node invasion and multiple tumors. Liver transplantation in patients with ICC should be confined to highly discreetly selected cases. Consequently, liver transplantation combined with neoadjuvant treatment for these cases may achieve an improved survival.