Medical College of Wisconsin
CTSICores SearchResearch InformaticsREDCap

Survival after Resection of Multiple Tumor Foci of Intrahepatic Cholangiocarcinoma. J Gastrointest Surg 2019 Nov;23(11):2239-2246

Date

03/20/2019

Pubmed ID

30887301

Pubmed Central ID

PMC6831534

DOI

10.1007/s11605-019-04184-2

Scopus ID

2-s2.0-85063213483 (requires institutional sign-in at Scopus site)   31 Citations

Abstract

BACKGROUND: Multiple tumor foci of intrahepatic cholangiocarcinoma (ICC) are often considered a contra-indication for resection. We sought to define long-term outcomes after resection of ICC in patients with multiple foci.

METHODS: Patients who underwent resection for ICC between 1990 and 2017 were identified from 12 major HPB centers. Outcomes of patients with solitary lesions, multiple lesions (ML), and oligometastases (OM) were compared. OM were defined as extrahepatic metastases spread to a single organ.

RESULTS: One thousand thirteen patients underwent resection of ICC. On final pathology, 185 patients (18.4%) had ML and 27 (2.7%) had OM. Median survival of patients with a solitary tumor was 43.2 months, while the median survival of patients with 2 tumors was 21.2 months; the median survival of patients with 3 or more tumors was 15.3 months (p < 0.001). Five-year survival was 43.3%, 28.0%, and 8.6%, respectively. The median survival of patients without OM was 37.8 months versus 14.9 months among patients with OM (p < 0.001); estimated 5-year survival was 39.3% and 10.6%, respectively. In multivariable analysis, the presence of two lesions was not an independent poor prognostic factor for OS (HR 1.19; 95%CI 0.90-1.57; p = 0.229). However, the presence of three or more tumors was an independent poor prognostic factor for OS (HR 1.97; 95%CI 1.48-2.64; p < 0.001).

CONCLUSION: Resection of multiple liver tumors for patients with ICC did not preclude 5-year survival: in particular, estimated 5-year OS for resection of two tumors was 28.0%.

Author List

Buettner S, Ten Cate DWG, Bagante F, Alexandrescu S, Marques HP, Lamelas J, Aldrighetti L, Gamblin TC, Maithel SK, Pulitano C, Margonis GA, Weiss M, Bauer TW, Shen F, Poultsides GA, Marsh JW, IJzermans JNM, Pawlik TM, Koerkamp BG

Author

Thomas Clark Gamblin MD Professor in the Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Aged
Bile Duct Neoplasms
Bile Ducts, Intrahepatic
Cholangiocarcinoma
Europe
Female
Hepatectomy
Humans
Male
Middle Aged
Survival Rate
United States