Actual over 10-year survival after liver resection for patients with intrahepatic cholangiocarcinoma
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Anfeng Si1,*, Jun Li1,*, Hongjun Xiang1,2,*, Shichao Zhang1, Shilei Bai1, Pinghua Yang3, Xiaofeng Zhang1, Yong Xia1,4, Kui Wang5, Zhenlin Yan1, Wan Yee Lau1,6, Lehua Shi1 and Feng Shen1
1Department of Hepatic Surgery IV, The Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China
2Department of Hepatobiliary Surgery, The Lanzhou General Hospital of People's Liberation Army, Gansu, China
3Department of Minimally Invasive Surgery, The Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China
4Department of Clinical Database, The Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China
5Department of Hepatic Surgery II, The Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China
6Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
*These authors have contributed equally to this work
Feng Shen, email: [email protected]
Keywords: intrahepatic cholangiocarcinoma, liver resection, long-term outcome, 10-year, actual survivors
Received: November 30, 2016 Accepted: April 27, 2017 Published: May 11, 2017
Partial hepatectomy is a potentially curative therapy for intrahepatic cholangiocarcinoma (ICC). Unfortunately, the overall surgical prognosis remains dismal and the actual 10-year survival has not been reported. This study aimed to document 10-year actual survival rates, identify the prognostic factors associated with 10-year survival rate, and analyze the characteristics of patients who survived ≥ 10 years. Among 251 patients who underwent curative liver resection for ICC between 2003 and 2006 at the Eastern Hepatobiliary Surgery Hospital, 21 patients (8.4%) survived ≥ 10 years. The 5-, 7-, and 10-year overall survival rates were 32.3%, 22.3% and 8.4%, respectively. The 10-year cumulative incidence of ICC-related death and recurrence were 80.9% and 85.7%, respectively. Multivariate analysis based on competing risk survival analysis identified that tumor > 5 cm was independently associated with ICC-related death and recurrence (hazard ratios: 1.369 and 1.445, respectively), in addition to carcinoembryonic antigen (CEA) >10 U/mL, carbohydrate antigen 19-9 (CA19-9) >39 U/mL, multiple nodules, vascular invasion, nodal metastasis and local extrahepatic invasion. Patients who survived ≥ 10 years had a longer time to first recurrence, lower levels of CEA, CA19-9 and alkaline phosphatase, less perioperative blood loss, solitary tumor, smaller tumor size, and absence of nodal metastasis or local extrahepatic invasion. In conclusion, a 10-year survival after liver resection for ICC is possible and can be expected in approximately 8.4% of patients.
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