Recurrence After Operative Management of Intrahepatic Cholangiocarcinoma

• Autor(a) principal: Hyder, O
• Data de Publicação: 2013
• Outros Autores: Hatzaras, I, Sotiropoulos, G, Paul, A, Alexandrescu, S, Marques, H, Pulitano, C, Barroso, E, Clary, B, Aldrighetti, L, Ferrone, C, Zhu, A, Bauer, T, Walters, D, Groeschl, R, Gamblin, C, Marsh, J, Nguyen, K, Turley, R, Popescu, I, Hubert, C, Meyer, S, Choti, M, Gigot, JF, Mentha, G, Pawlik, T
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://hdl.handle.net/10400.17/1291
• topic: Colangiocarcinoma; Neoplasias das Vias Biliares; Vias Biliares Intra-Hepáticas; Sobrevivência Livre de Doença; Estimativa de Kaplan-Meier; Neoplasias Hepáticas; Metástases Linfáticas; Invasão Neoplásica; Factores de Risco; Recidiva Neoplásica Local

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.