Factors influencing the prognosis of patients with intrahepatic cholangiocarcinoma

Abstract

Background and aims: The outcome of surgical treatment of patients with intrahepatic cholangiocarcinoma (ICC) is poor. This study was designed to analyze prognostic factors following surgical treatment for ICC.

Patients and methods: A structured telephone interview was conducted in 132 patients who were surgically treated for ICC. Fifteen clinical and pathological factors that may influence post-operative survival were analyzed by using Cox proportional hazards model.

Results: The accumulative 1-, 3-, 5-year survival rate of the 132 patients was 51.3%, 21.6%, and 11.8% respectively. The mean survival time in patients with elevated serum carbohydrate antigen (CA) 19-9 at the time of the operation was shorter than in patients with normal serum CA19-9 (9.6 +/- 24.7 vs 16.1 +/- 6 months, P < 0.01). The median survival time in patients with well-differentiated carcinoma was longer than in those with poorly differentiated ICC (23.9 +/- 7.8 vs. 11.2 +/- 5.0 months, P < 0.01). Patients who were treated with hepatectomy and lymph node dissection had a longer survival time than those treated with hepatectomy only (16.0 +/- 5.8 vs 10.2 +/- 3.6 months, P < 0.01). Multivariate analysis showed that mode of surgical treatment, lymph node metastasis, serum level of CA 19-9 and pathological differentiation grade of ICC predicted postoperative survival.

Conclusions: Hepatectomy with lymph node dissection is associated with an improved survival for patients with ICC. This strategy may be recommended for the surgical treatment of ICC.