Operations for Intrahepatic Cholangiocarcinoma: Single-Institution Experience of 158 Patients

Lang, Hauke; Sotiropoulos, Georgios C.; Sgourakis, George; Schmitz, Klaus J.; Paul, Andreas; Hilgard, Philip; Zöpf, Thomas; Trarbach, Tanja; Malagó, Massimo; Baba, Hideo A.; Broelsch, Christoph E.

doi:10.1016/j.jamcollsurg.2008.10.017

« Previous Next »Journal of the American College of Surgeons
Volume 208, Issue 2 , Pages 218-228, February 2009

Operations for Intrahepatic Cholangiocarcinoma: Single-Institution Experience of 158 Patients

Hauke Lang, MA, MD, FACS
- Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Essen, Germany
- Correspondence address: Hauke Lang, MA, MD, FACS, Department of General and Abdominal Surgery, Johannes Gutenberg University Hospital Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
Georgios C. Sotiropoulos, MD
- Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Essen, Germany
George Sgourakis, MD
- Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Essen, Germany
Klaus J. Schmitz, MD
- Institute of Pathology and Neuropathology, University Hospital Essen, Essen, Germany
Andreas Paul, MD, FRCS
- Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Essen, Germany
Philip Hilgard, MD
- Department of Gastroenterology and Hepatology, University Hospital Essen, Essen, Germany
Thomas Zöpf, MD
- Department of Gastroenterology and Hepatology, University Hospital Essen, Essen, Germany
Tanja Trarbach, MD
- Department of Medical Oncology, University Hospital Essen, Essen, Germany
Massimo Malagó, MD
- Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Essen, Germany
Hideo A. Baba, MD
- Institute of Pathology and Neuropathology, University Hospital Essen, Essen, Germany
Christoph E. Broelsch, MD, FACS
- Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Essen, Germany

Received 28 July 2008; received in revised form 5 October 2008; accepted 8 October 2008.

Background

Intrahepatic cholangiocarcinoma (ICC) is a rare primary liver malignancy. Until now, outcomes and prognostic factors after liver resection for these tumors have not been well-documented.

Study Design

Between April 1998 and December 2006, a total of 158 patients underwent surgical exploration in our institution for intended liver resection of ICC. Prospectively collected data of patients undergoing liver resection (n = 83) were analyzed with regard to preoperative findings, operative details, perioperative morbidity and mortality, pathologic findings, outcomes measured by tumor recurrence and survival, and prognostic factors for outcomes.

Results

Tumors were solitary in 47 patients. R0 resections were achieved in 53 patients. Vascular infiltration and lymph node metastasis were detected in 41% and 34%, respectively. After resection, the calculated 1-, 3-, and 5-year-survival rates were 71%, 38%, and 21%, respectively, with corresponding rates of 83%, 50%, and 30% in R0 resections. For 14 variables evaluated, only gender (p = 0.008), Union Internationale Contre le Cancer stage (p = 0.014), and R classification (p = 0.001) showed predictive value in the multivariate Cox proportional hazard regression.

Conclusions

Results presented outline that an R0 resection leads to substantially prolonged survival in ICC and represents the considerable input of the surgeon to the outcomes of these patients. Union Internationale Contre le Cancer stage remains an important factor.