Long-term results of surgical treatment of intrahepatic cholangiocarcinoma

Close metadata

Recommended articles:

Cicatricial tracheal stenosis. Is prevention possible? A single-region experience. Pirogov Russian Journal of Surgery. 2023;(6):42-47

Modern view on postoperative perineal hernias surgical treatment. Russian Journal of Operative Surgery and Clinical Anatomy. 2023;(1):34-40

Postoperative pain assessment in patients with Crohn’s disease. Russian Journal of Evidence-Based Gastroenterology. 2023;(1):37-41

Long-term results of surgical treatment of patients with cerebral arterial aneurysms. S.S. Korsakov Journal of Neurology and Psychiatry. 2023;(3-2):41-49

Surgery for lung cancer in elderly and senile patients: a ten-year experience of two centers. P.A. Herzen Journal of Oncology. 2023;(2):11-18

Problems of a comprehensive assessment of the malignancy potential of pancreatic cystic neoplasia using endoscopic ultrasonography and fine needle aspiration puncture. Endoscopic Surgery. 2023;(2):11-18

Primary spine and spinal cord tumours and pregnancy. Russian Bulletin of Obstetrician-Gynecologist. 2023;(2):88-94

Results of surgical treatment in patients with critical ischemia of the lower limbs and complications of endovascular interventions. Russian Journal of Cardiology and Cardiovascular Surgery. 2017;(1):47-50

Early and Long-term results of surgical treatment of combined carotid and coronary atherosclerotic lesion. Russian Journal of Cardiology and Cardiovascular Surgery. 2017;(1):22-27

Surgical myectomy in patients with obstructive hypertrophic cardiomyopathy and concomitant cardiac diseases. Russian Journal of Cardiology and Cardiovascular Surgery. 2023;(3):297-308

Objective. To evaluate the long-term outcomes of surgical treatment of intrahepatic cholangiocarcinoma depending tumor dimensions, vascular invasion, lymph node metastases, cellular differentiation and quality of resection. Material and methods. There were 46 patients with intrahepatic cholangiocellular cancer. Extended hemihepatectomy was made in 14 patients (30.4%), resection of two and three liver segments — in 17 cases (36.9%), standard hemihepatectomy — in 15 patients (32.6%). Liver resection was combined with extrahepatic bile duct resection in 5 (10.9%) patients. Liver resection was followed by biopsy of specimens. Dimension and number of tumors, differentiation grade, resection margin, liver capsule invasion, vascular invasion and regional lymph node metastases were analyzed. Forty-four (95.6%) patients were followed-up in long-term postoperative period. Statistical analysis was performed using Statistica 13.2 (Dell Inc., USA) and IBM SPSS Statistics v.25 (IBM Corp., USA) software package. Survival was analyzed using the Kaplan-Meier method. Overall 1-, 3- and 5-year survival rates with two-sided 95% confidence intervals (95% CI) were calculated using IBM SPSS Statistics v.25 software. Results. Median survival was 37 months, 1-year — 75.9% (60.9-90.9%), 3-year — 57.6% (35.5-79.6%), 5-year — 36% (8.2-63.7%). Median survival after R1 resection was 37 months, R2 resection — 12 months. Median survival was not achieved in R0 group. We found significant differences in overall survival depending on quality of resection. Tumor dimension over 5 cm, low-grade adenocarcinoma, microvascular invasion and lymph node metastases were associated with impaired postoperative survival. However, differences were not significant. Conclusion. The main surgical strategy in patients with intrahepatic cholangiocarcinoma should be ensuring microscopically negative resection margin.

Keywords:

intrahepatic cholangiocellular carcinoma

surgical treatment

radical surgery

long-term results

Authors:

B.N. Gurmikov

Vishnevsky National Medical Research Center of Surgery, Moscow, Russia

V.A. Vishnevskiĭ

FGBU "Institut khirurgii im. A.V. Vishnevskogo" Minzdrava Rossii, Moskva

Yu.A. Kovalenko

Federal state budgetary institution «A.A. Vishnevsky Institute of Surgery», Russian Ministry of Health (director: B.A. Kubyshkin, member of Russian Academy of Sciences]

A.V. Chzhao

FGBU "Institut khirurgii im. A.V. Vishnevskogo" Minzdrava Rossii, Moskva

List of references:

Grishechkina IA, Viktorova IA, Trukhan DI, Kondratyeva NA. Actual aspects of diagnostics of intrahepatic cholangiocarcinoma. 2016;11(1):61-65. (In Russ.)
Rahnemai-Azar AA, Weisbrod AB, Dillhoff M, Schmidt C, Pawlik TM. Intrahepatic cholangiocarcinoma: current management and emerging therapies. 2017;11(5):439-449.
Tyson GL, El-Serag HB. Risk factors for cholangiocarcinoma. . 2011;54(1):173-184.
Buettner S, van Vugt JL, Ijzermans JN, Groot Koerkamp B. Intrahepatic cholangiocarcinoma: current perspectives. . 2017;10:1131-1142.
Morise Z, Sugioka A, Tokoro T, Tanahashi Y, Okabe Y, Kagawa T, Takeura C. Surgery and chemotherapy for intrahepaticcholangiocarcinoma. . 2010;27;2(2):58-64.
Akhaladze DG, Alikhanov RB, Efanov MG, Kim PP, Kazakov IV, Vankovich AN, Melekhina OV, Kulezneva YuV, Tsvirkun VV. Intrahepatic cholangiocarcinoma with invasion of blood vessels: is surgical treatment justified? 2018;6:49-57. (In Russ.)
Ribero D, Pinna AD, Guglielmi A, Ponti A, Nuzzo G, Giulini SM, Aldrighetti L, Calise F, Gerunda GE, Tomatis M, Amisano M, Berloco P, Torzilli G, Capussotti L. Surgical approach for long-term survival of patients with intrahepatic cholangiocarcinoma: a multi institutional analysis of 434 patients. 2012;147(12):1107-1113.
Yang J, Yan LN. Current status of intrahepatic cholangiocarcinoma. . 2008;14(41):6289-6297.
De Jong MC, Nathan H, Sotiropoulos GC, Paul A, Alexandrescu S, Marques H, Pulitano C, Barroso E, Clary BM, Aldrighetti L, Ferrone CR, Zhu AX, Bauer TW, Walters DM, Gamblin TC, Nguyen KT, Turley R, Popescu I, Hubert C, Meyer S, Schulick RD, Choti MA, Gigot JF, Mentha G, Pawlik TM. Intrahepatic cholangiocarcinoma: an international multi-institutional analysis of prognostic factors and lymph node assessment. . 2011;29(23):3140-3145.
Carpizo DR, D’Angelica M. Management and extent of resection for intrahepatic cholangiocarcinoma. 2009;18(2): 289-305.
Mavros MN, Economopoulos KP, Alexiou VG, Pawlik TM. Treatment and prognosis for patients with intrahepatic cholangiocarcinoma: systematic review and meta-analysis. . 2014;149(6): 565-574.
DeOliveira ML, Cunningham SC, Cameron JL, Kamangar F, Winter JM, Lillemoe KD, Choti MA, Yeo CJ, Schulick RD. Cholangiocarcinoma: thirty-one-year experience with 564 patients at a single institution. 2007;245:755-762.
Choi SB, Kim KS, Choi JY, Park SW, Choi JS, Lee WJ, Chung JB. The prognosis and survival outcome of intrahepatic cholangiocarcinoma following surgical resection: association of lymph node metastasis and lymph node dissection with survival. . 2009;16(11):3048-3056.
Lang H, Sotiropoulos GC, Sgourakis G, Schmitz KJ, Paul A, Hilgard P, Zöpf T, Trarbach T, Malagó M, Baba HA, Broelsch CE. Operations for intrahepatic cholangiocarcinoma: single-institution experience of 158 patients. . 2009;208(2):218-228.
Doussot A, Groot-Koerkamp B, Wiggers J K, Chou J, Gonen M, De Matteo RP, Allen PJ, Kingham TP, D’Angelica MI, Jarnagin WR. Outc13omes after Resection of Intrahepati Cholangiocarcinoma: External Validation and Comparison of Prognostic Models. . 2015;221(2):452-461.
Murakami Y, Uemura K, Sudo T, Hashimoto Y, Nakashima A, Kondo N, Sakabe R, Ohge H, Sueda T. Prognostic factors after surgical resection for intrahepatic, hilar, and distal cholangiocarcinoma. 2011;18:651-658.
Tabrizian P, Jibara G, Hechtman JF, Franssen B, Labow DM, Schwartz ME, Thung SN, Sarpel U. Outcomes following resection of intrahepatic cholangiocarcinoma. 2015;17(4):344-351.
Patyutko YuI, Polyakov AN, Kotelnikov AG, Sagaydak IV, Gakhramanov AD, Chistyakova OV, Moroz EA. Surgical and combined treatment of patients with cholangiocellular cancer. . 2015;11: 11-18. (In Russ.)
Nathan H, Pawlik TM, Wolfgang CL, Choti MA, Cameron JL, Schulick RD. Trends in survival after surgery for cholangiocarcinoma: a 30-year population-based seer database analysis. . 2007;11(11):1588-1496.
Brierley JD, Gospodarowicz MK, Wittekind C. . Eighth Edition. 2017.
Doussot A, Gonen M, Wiggers JK, Groot-Koerkamp B, DeMatteo RP, Fuks D, Allen PJ, Farges O, Kingham TP, Regimbeau JM, D’Angelica MI, Azoulay D, Jarnagin WR. Recurrence patterns and disease-free survival after resection of intrahepatic cholangiocarcinoma: preoperative and postoperative prognostic models. . 2016;223:493-505.
Hyder O, Marques H, Pulitano C, Marsh JW, Alexandrescu S, Bauer TW, Gamblin TC, Sotiropoulos GC, Paul A, Barroso E, Clary BM, Aldrighetti L, Ferrone CR, Zhu AX, Popescu I, Gigot JF, Mentha G, Feng S, Pawlik TM. A nomogram to predict long-term survival after resection for intrahepatic cholangiocarcinoma:an eastern and western experience. 2014;149(5):432-438.
Amin MB Edge S Greene F, Byrd DR, Brookland RK, Washington MK, Gershenwald JE, Compton CC, Hess KR, Sullivan DC, Jessup JM, Brierley JD, Gaspar LE, Schilsky RL, Balch CM, Winchester DP, Asare EA, Madera M, Gress DM, Meyer LR. AJCC cancer staging manual. MBA: American Joint Committee on Cancer. . 2017.
Rodríguez‐Perálvarez M, Luong TV, Andreana L, Meyer T, Dhillon AP, Burroughs AK. A systematic review of microvascular invasion in hepatocellular carcinoma: diagnostic and prognostic variability. . 2013;20:325‐339.
Shao C, Chen J, Shi J, Huang L, Qiu Y. Histological сlassification of microvascular invasion to predict prognosis in intrahepatic cholangiocarcinoma. 2017;10(7):7674-7681.
Hu L-S, Weiss M, Popescu I, Marques HP, Aldrighetti L, Maithel SK, Pulitano C, Bauer TW, Shen F, Poultsides GA, Soubrane O, Martel G, Koerkamp BG, Itaru E, Pawlik TM. Impact of microvascular invasion on clinical outcomes after curative‐intent resection for intrahepatic cholangiocarcinoma. . 2019;119:21‐29.
Nakagawa T, Kamiyama T, Kurauchi N, Matsushita M, Nakanishi K, Kamachi H, Kudo T, Todo S. Number of lymph node metastases is a significant prognostic factor in intrahepatic cholangiocarcinoma. . 2005;29(6):728-733.
Shimada K, Sano T, Nara S, Esaki M, Sakamoto Y, Kosuge T, Ojima H. Therapeutic value of lymph node dissection during hepatectomy in patients with intrahepatic cholangiocellular carcinoma with negative lymph node involvement. 2009;145(4):411-416.
Kim DH, Choi DW, Choi SH, Heo JS, Kow AW. Is there a role for systematic hepatic pedicle lymphadenectomy in intrahepatic cholangiocarcinoma? A review of 17 years of experience in a tertiary institution. . 2015 Apr;157(4):666-675.
Spolverato G, Yakoob MY, Kim Y, Alexandrescu S, Marques HP, Lamelas J, Aldrighetti L, Gamblin TC, Maithel SK, Pulitano C, Bauer TW, Shen F, Poultsides GA, Marsh JW, Pawlik TM. The Impact of Surgical Margin Status on Long-Term Outcome After Resection for Intrahepatic Cholangiocarcinoma. . 2015;22(12):4020-4028.

Close metadata