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BACKGROUND:
Hepatectomy is the only chance of cure for patient with intrahepatic cholangiocarcinoma (ICC), because there is a lack of other effective treatments for achieving an actual 5 year survival. However clinicopathological feature predicting 5-year survival after hepatectomy has not been well clarified.
METHODS:
113 consecutive ICC patients with mass-forming (MF) macroscopic tumor type and MF plus periductal infiltrating (PI) type, who underwent surgical resection at a single institution between January 1990 and December 2006, were retrospectively analyzed. Patients who died of unknown causes, and who was lost to follow up within 5 year were excluded from the study. The clinicopathologic features of patients who survived more than 5 years were compared with those died within 5 years.
RESULTS:
Of all 113 patients underwent surgical resection, 33 patients (29.2%) survived more than 5 years.
In univariate analysis, MF type (p=0.015), preservation of extra bile duct resection (p=0.014), operation without blood transfusion (p=0.001), absence of intrahepatic metastasis (p=0.006), absence of vascular invasion (p=0.022), negative lymph node involvement (p<0.001), and microscopic curative resection (p=0.001) were significantly related to 5 year survival.
Multivariate analysis showed that operation without blood transfusion, absence of intrahepatic metastasis and negative lymph node involvement were independent factors associated with survival for more than 5 years, with odds ratios (95% confidence interval) of 6.743 (1.784-25.491; p=0.005), 4.302 (1.391-13.306; p=0.011), 3.886 (1.401-10.664; p=0.009), respectively.
CONCLUSION
In MF and MF+PI type of ICC, hepatectomy without blood transfusion, absence of intrahepatic metastasis and negative lymph node involvement significantly contribute an actual 5 year survival.