The prognostic impact of microvascular invasion on patients with intrahepatic cholangiocarcinoma after R0 resections

Abstract

Objective To study the clinical impact of microvascular invasion (MVI) on patients with intrahepatic cholangiocarcinoma (ICC) after R0 resections. Methods The clinicopathological data of 359 patients with ICC who underwent R0 resection in the Zhongshan Hospital, Fudan University between January 2000 and December 2008 were retrospectively studied. Univariate analysis and multivariate analysis were carried out to study factors related to postoperative survival outcomes and recurrence. The impact of MVI on patients with ICC after R0 resection was studied. Results The incidence of MVI was 13.6% in the study cohort. MVI was correlated with HBV infection (P<0.05), liver cirrhosis (P<0.05) and tumor differentiation (P<0.05). The 1-, 3-, 5-year overall survival (OS) between the MVI positive and negative groups were 50.0%, 20.9%, 12.2% and 63.9%, 33.1%, 22.0% respectively (P<0.05), and the median survival time was 13 months and 18.5 months (P<0.05). The 1-, 3-, 5-year recurrence free survival (RFS) rates between the MVI positive and negative groups were 29.7%, 12.7%, 8.5% and 50.6%, 26.9%, 18.4%, respectively (P<0.05), and the median recurrence free survival time was 8 months and 12.5 months (P<0.05). Multivariate analysis showed that MVI was an independent risk factor affecting recurrence after R0 resection (HR 1.852, 95% CI: 1.075~3.195, P<0.05). Conclusions The occurrence of MVI in ICC patients was associated with hepatitis B infection. MVI was an independent risk factor affecting recurrence in ICC patients after R0 resection. However, it was not an independent risk factor of overall survival in patients after R0 resection. The clinical impact of MVI on patients with ICC was not as strong as for hepatocellular carcinoma. Key words: Intrahepatic cholangiocarcinoma; R0 resection; Microvascular invasion; Prognosis