Intrahepatic cholangiocarcinoma : Results after 84 resections

• Published in: Chirurg 2018-05, Vol.89 (5), p.374-380
• Main Authors: Neeff, H P, Holzner, P A, Menzel, M, Bronsert, P, Klock, A, Lang, S A, Fichtner-Feigl, S, Hopt, U T, Makowiec, F
• Format: Article
• Language: ger
• Subjects: Bile Duct Neoplasms - surgery; Bile Ducts, Intrahepatic; Cholangiocarcinoma - surgery; Hepatectomy; Humans; Prognosis; Retrospective Studies; Survival Rate; Treatment Outcome
• ISSN: 1433-0385
• DOI: 10.1007/s00104-018-0609-2

The incidence of intrahepatic cholangiocarcinoma (ICC) is increasing worldwide. Surgical resection is the only curative treatment option. This study analyzed the prognostic factors after resection of ICC. A total of 84 patients were surgically treated under potentially curative intent. Perihilar and distal cholangiocarcinomas were excluded. The 5‑year survival was analyzed with respect to tumor stage (TNM), number of lesions, complete surgical resection (R0), peritoneal carcinosis and postoperative complications. The 5‑year survival was 27% and 77% of patients underwent R0 resections. In the univariate analysis a T stage >2, an N+ situation or an R+ resection as well as peritoneal and multilocular intrahepatic spread were associated with a poorer prognosis. Postoperative complications also negatively influenced survival. On multivariate analysis the absence of peritoneal spread, node-negative tumor stages, singular hepatic lesions and a low T stage as well as the absence of complications were associated with improved survival. The prognosis of ICC is poor even after successful surgical resection. Well-known tumor characteristics such as TNM are relevant prognostic factors. Surgical resection is accompanied by postoperative complications (most frequently biliary), which negatively influence survival. Adjuvant strategies are urgently needed to improve long-term survival even after complete surgical resection.