TY - JOUR
T1 - Recurrence after operative management of intrahepatic cholangiocarcinoma
AU - Hyder, Omar
AU - Hatzaras, Ioannis
AU - Sotiropoulos, Georgios C.
AU - Paul, Andreas
AU - Alexandrescu, Sorin
AU - Marques, Hugo
AU - Pulitano, Carlo
AU - Barroso, Eduardo
AU - Clary, Bryan M.
AU - Aldrighetti, Luca
AU - Ferrone, Cristina R.
AU - Zhu, Andrew X.
AU - Bauer, Todd W.
AU - Walters, Dustin M.
AU - Groeschl, Ryan
AU - Gamblin, T. Clark
AU - Marsh, J. Wallis
AU - Nguyen, Kevin T.
AU - Turley, Ryan
AU - Popescu, Irinel
AU - Hubert, Catherine
AU - Meyer, Stephanie
AU - Choti, Michael A.
AU - Gigot, Jean Francois
AU - Mentha, Gilles
AU - Pawlik, Timothy M.
PY - 2013/6
Y1 - 2013/6
N2 - Introduction: Data on recurrence after operation for intrahepatic cholangiocarcinoma (ICC) are limited. We sought to investigate rates and patterns of recurrence in patients after operative intervention for ICC. Methods: We identified 301 patients who underwent operation for ICC between 1990 and 2011 from an international, multi-institutional database. Clinicopathologic data, recurrence patterns, and recurrence-free survival (RFS) were analyzed. Results: During the median follow up duration of 31 months (range 1-208), 53.5% developed a recurrence. Median RFS was 20.2 months and 5-year actuarial disease-free survival, 32.1%. The most common site for initial recurrence after operation of ICC was intrahepatic (n = 98; 60.9%), followed by simultaneous intra- and extrahepatic disease (n = 30; 18.6%); 33 (21.0%) patients developed extrahepatic recurrence only as the first site of recurrence. Macrovascular invasion (hazard ratio [HR], 2.08; 95% confidence interval [CI], 1.34-3.21; P <.001), nodal metastasis (HR, 1.55; 95% CI, 1.01-2.45; P =.04), unknown nodal status (HR, 1.57; 95% CI, 1.10-2.25; P =.04), and tumor size ≥5 cm (HR, 1.84; 95% CI, 1.28-2.65; P <.001) were independently associated with increased risk of recurrence. Patients were assigned a clinical score from 0 to 3 according to the presence of these risk factors. The 5-year RFS for patients with scores of 0, 1, 2, and 3 was 61.8%, 36.2%, 19.5%, and 9.6%, respectively. Conclusion: Recurrence after operative intervention for ICC was common. Disease recurred both at intra- and extrahepatic sites with roughly the same frequency. Factors such as lymph node metastasis, tumor size, and vascular invasion predict highest risk of recurrence.
AB - Introduction: Data on recurrence after operation for intrahepatic cholangiocarcinoma (ICC) are limited. We sought to investigate rates and patterns of recurrence in patients after operative intervention for ICC. Methods: We identified 301 patients who underwent operation for ICC between 1990 and 2011 from an international, multi-institutional database. Clinicopathologic data, recurrence patterns, and recurrence-free survival (RFS) were analyzed. Results: During the median follow up duration of 31 months (range 1-208), 53.5% developed a recurrence. Median RFS was 20.2 months and 5-year actuarial disease-free survival, 32.1%. The most common site for initial recurrence after operation of ICC was intrahepatic (n = 98; 60.9%), followed by simultaneous intra- and extrahepatic disease (n = 30; 18.6%); 33 (21.0%) patients developed extrahepatic recurrence only as the first site of recurrence. Macrovascular invasion (hazard ratio [HR], 2.08; 95% confidence interval [CI], 1.34-3.21; P <.001), nodal metastasis (HR, 1.55; 95% CI, 1.01-2.45; P =.04), unknown nodal status (HR, 1.57; 95% CI, 1.10-2.25; P =.04), and tumor size ≥5 cm (HR, 1.84; 95% CI, 1.28-2.65; P <.001) were independently associated with increased risk of recurrence. Patients were assigned a clinical score from 0 to 3 according to the presence of these risk factors. The 5-year RFS for patients with scores of 0, 1, 2, and 3 was 61.8%, 36.2%, 19.5%, and 9.6%, respectively. Conclusion: Recurrence after operative intervention for ICC was common. Disease recurred both at intra- and extrahepatic sites with roughly the same frequency. Factors such as lymph node metastasis, tumor size, and vascular invasion predict highest risk of recurrence.
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U2 - 10.1016/j.surg.2012.12.005
DO - 10.1016/j.surg.2012.12.005
M3 - Article
C2 - 23499016
AN - SCOPUS:84878011273
SN - 0039-6060
VL - 153
SP - 811
EP - 818
JO - Surgery (United States)
JF - Surgery (United States)
IS - 6
ER -