Factors influencing the prognosis of patients with intrahepatic cholangiocarcinoma

Background and aims : The outcome of surgical treatment of patients with intrahepatic cholangiocarcinoma (ICC) is poor. This study was designed to analyze prognostic factors following surgical treatment for ICC. Patients and methods : A structured telephone interview was conducted in 132 patients who were surgically treated for ICC. Fifteen clinical and pathological factors that may influence post-operative survival were analyzed by using Cox proportional hazards model. Results : The accumulative 1-, 3-, 5-year survival rate of the 132 patients was 513%, 21.6%, and 11.8% respectively. The mean survival time in patients with elevated serum carbohydrate antigen (CA) 19-9 at the time of the operation was shorter than in patients with normal serum CA,19-9 (9.6 +/- 24.7 vs 16.1 +/- 6 months, P < 0.01). The median survival time in patients with well-differentiated carcinoma was longer than in those with poorly differentiated ICC (23.9 +/- 7.8 vs. 11.2 +/- 5.0 months, P < 0.01). Patients who were treated with hepatectomy and lymph node dissection had a longer survival time than those treated with hepatectomy only (16.0 +/- 5.8 vs 10.2 +/- 3.6 months, P < 0.01). Multivariate analysis showed that mode of surgical treatment, lymph node metastasis, serum level of CA 19-9 and pathological differentiation grade of ICC predicted postoperative survival. Conclusions : Hepatectomy with lymph node dissection is associated with an improved survival for patients with ICC. This strategy may be recommended for the surgical treatment of ICC. (Acta gastroenterol. belg.., 2012, 75, 215-218).