Recurrence After Operative Management of Intrahepatic Cholangiocarcinoma
Autor(a) principal: | |
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Data de Publicação: | 2013 |
Outros Autores: | , , , , , , , , , , , , , , , , , , , , , , , , |
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 |
Resumo: | 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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Recurrence After Operative Management of Intrahepatic CholangiocarcinomaColangiocarcinomaNeoplasias das Vias BiliaresVias Biliares Intra-HepáticasSobrevivência Livre de DoençaEstimativa de Kaplan-MeierNeoplasias HepáticasMetástases LinfáticasInvasão NeoplásicaFactores de RiscoRecidiva Neoplásica LocalINTRODUCTION: 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.ElsevierRepositório do Centro Hospitalar Universitário de Lisboa Central, EPEHyder, OHatzaras, ISotiropoulos, GPaul, AAlexandrescu, SMarques, HPulitano, CBarroso, EClary, BAldrighetti, LFerrone, CZhu, ABauer, TWalters, DGroeschl, RGamblin, CMarsh, JNguyen, KTurley, RPopescu, IHubert, CMeyer, SChoti, MGigot, JFMentha, GPawlik, T2013-06-12T10:48:50Z20132013-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.17/1291engSurgery. 2013 Jun;153(6):811-8info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-03-10T09:30:46Zoai:repositorio.chlc.min-saude.pt:10400.17/1291Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T17:18:49.583965Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Recurrence After Operative Management of Intrahepatic Cholangiocarcinoma |
title |
Recurrence After Operative Management of Intrahepatic Cholangiocarcinoma |
spellingShingle |
Recurrence After Operative Management of Intrahepatic Cholangiocarcinoma Hyder, O 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 |
title_short |
Recurrence After Operative Management of Intrahepatic Cholangiocarcinoma |
title_full |
Recurrence After Operative Management of Intrahepatic Cholangiocarcinoma |
title_fullStr |
Recurrence After Operative Management of Intrahepatic Cholangiocarcinoma |
title_full_unstemmed |
Recurrence After Operative Management of Intrahepatic Cholangiocarcinoma |
title_sort |
Recurrence After Operative Management of Intrahepatic Cholangiocarcinoma |
author |
Hyder, O |
author_facet |
Hyder, O 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 |
author_role |
author |
author2 |
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 |
author2_role |
author author author author author author author author author author author author author author author author author author author author author author author author author |
dc.contributor.none.fl_str_mv |
Repositório do Centro Hospitalar Universitário de Lisboa Central, EPE |
dc.contributor.author.fl_str_mv |
Hyder, O 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 |
dc.subject.por.fl_str_mv |
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 |
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 |
description |
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. |
publishDate |
2013 |
dc.date.none.fl_str_mv |
2013-06-12T10:48:50Z 2013 2013-01-01T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10400.17/1291 |
url |
http://hdl.handle.net/10400.17/1291 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Surgery. 2013 Jun;153(6):811-8 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Elsevier |
publisher.none.fl_str_mv |
Elsevier |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
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RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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