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. 2022 Oct;46(10):2459-2467.
doi: 10.1007/s00268-022-06655-1. Epub 2022 Jul 11.

Factors of Early Recurrence After Resection for Intrahepatic Cholangiocarcinoma

Alexandra Nassar  1 , Stylianos Tzedakis  2 , Rémy Sindayigaya  2 , Christian Hobeika  3 , Ugo Marchese  2 , Julie Veziant  2 , Tatiana Codjia  3 , Aurélie Beaufrère  4 , Alix Dhote  2 , Marie Strigalev  2 , François Cauchy  3 , David Fuks  2
Affiliations

Factors of Early Recurrence After Resection for Intrahepatic Cholangiocarcinoma

Alexandra Nassar et al. World J Surg. 2022 Oct.

Abstract

Background: Two-thirds of patients undergoing liver resection for intrahepatic cholangiocarcinoma experience recurrence after surgery. Our aim was to identify factors associated with early recurrence after resection for intrahepatic cholangiocarcinoma.

Methods: Patients with intrahepatic cholangiocarcinoma undergoing curative intent resection (complete resection and lymphadenectomy) were included in two centers between 2005 and 2021 and were divided into three groups: early recurrence (< 12 months after resection), delayed recurrence (> 12 months), and no recurrence. Patients experiencing early (< 90 days) postoperative mortality were excluded.

Results: Among 120 included patients, 44 (36.7%) experienced early recurrence, 24 (20.0%) experienced delayed recurrence, and 52 (43.3%) did not experience recurrence after a median follow-up of 59 months (IQR: 26-113). The median recurrence-free survival was 16 months (95% CI: 9.6-22.4). Median overall survival was 55 months (95% CI: 45.7-64.3), while it was 25 months for patients with early recurrence (p < 0.001). Patients with early recurrence had significantly larger tumors (59.1% of tumors > 70 mm in early vs. 58.3% in delayed vs. 26.9% in no recurrence group, p = 0.002), multiple lesions (65.9% vs. 29.2% vs. 11.5%, p < 0.001), and positive lymph nodes (N +) (38.6% vs. 37.5% vs. 11.5%, p = 0.005). In multivariable analysis, presence of multiple lesions (OR: 9.324; 95% CI: 3.051-28.489; p < 0.001) and positive lymph nodes (OR: 3.307. 95% CI: 1.001-11.011. p = 0.05) were associated with early recurrence.

Conclusion: Early recurrence after curative resection of intrahepatic cholangiocarcinoma is frequent and is associated with the presence of multiple lesions and positive lymph nodes, raising the question of surgery's futility in this context.

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