Objectives: The objective of the current study was to characterize prognostic factors related to long-term recurrence-free survival after curative-intent resection of intrahepatic cholangiocarcinoma (ICC). Methods: Data on patients who underwent curative-intent resection for ICC between 2000 and 2020 were collected from an international multi-institutional database. Prognostic factors were investigated among patients who recurred within 5 years versus long-term survivors who survived more than 5 years with no recurrence. Results: Among 635 patients who underwent curative-intent resection for ICC, 104 (16.4%) patients were long-term survivors with no recurrence beyond 5 years after surgery. Patients who survived for more than 5 years with no recurrence were more likely to have less aggressive tumor features, as well as have undergone an R0 resection versus patients who recurred within 5 years after resection. On multivariable analysis, tumor size (>5 cm) (HR: 1.535, 95% CI: 1.254–1.879), satellite lesions (HR: 1.253, 95% CI: 1.003–1.564), and lymph node metastasis (HR: 1.733, 95% CI: 1.349–2.227) were independently associated with recurrence within 5 years. Patients who recurred beyond 5 years (n = 23), 2–5 years (n = 60), and within 2 years (n = 471) had an incrementally worse post-recurrence survival (PRS, 28.0 vs. 20.0 vs. 12.0 months, p = 0.032). Among patients with N0 status, tumor size (>5 cm) (HR: 1.612, 95% CI: 1.087–2.390) and perineural invasion (PNI) (HR: 1.562,95% CI: 1.081–2.255) were risk factors associated with recurrence. Among patients with N1 disease, only a minority (5/128, 3.9%) of patients survived with no recurrence to 5 years. Conclusion: Roughly 1 in 6 patients survived for more than 5 years with no recurrence following curative-intent resection of ICC. Among N0 patients, tumor recurrence was associated with tumor size and PNI. Only a small subset of N1 patients experienced long-term survival.
Long-term survivors after curative-intent resection for intrahepatic cholangiocarcinoma / Ma, Z. -J.; Xiang, J. -X.; Weiss, M.; Popescu, I.; Marques, H. P.; Aldrighetti, L.; Maithel, S. K.; Pulitano, C.; Bauer, T. W.; Shen, F.; Poultsides, G. A.; Soubrane, O.; Martel, G.; Koerkamp, B. G.; Itaru, E.; Lyu, Y.; Zhang, X. -F.; Pawlik, T. M.. - In: JOURNAL OF SURGICAL ONCOLOGY. - ISSN 0022-4790. - (2024). [10.1002/jso.27739]
Long-term survivors after curative-intent resection for intrahepatic cholangiocarcinoma
Aldrighetti L.;
2024-01-01
Abstract
Objectives: The objective of the current study was to characterize prognostic factors related to long-term recurrence-free survival after curative-intent resection of intrahepatic cholangiocarcinoma (ICC). Methods: Data on patients who underwent curative-intent resection for ICC between 2000 and 2020 were collected from an international multi-institutional database. Prognostic factors were investigated among patients who recurred within 5 years versus long-term survivors who survived more than 5 years with no recurrence. Results: Among 635 patients who underwent curative-intent resection for ICC, 104 (16.4%) patients were long-term survivors with no recurrence beyond 5 years after surgery. Patients who survived for more than 5 years with no recurrence were more likely to have less aggressive tumor features, as well as have undergone an R0 resection versus patients who recurred within 5 years after resection. On multivariable analysis, tumor size (>5 cm) (HR: 1.535, 95% CI: 1.254–1.879), satellite lesions (HR: 1.253, 95% CI: 1.003–1.564), and lymph node metastasis (HR: 1.733, 95% CI: 1.349–2.227) were independently associated with recurrence within 5 years. Patients who recurred beyond 5 years (n = 23), 2–5 years (n = 60), and within 2 years (n = 471) had an incrementally worse post-recurrence survival (PRS, 28.0 vs. 20.0 vs. 12.0 months, p = 0.032). Among patients with N0 status, tumor size (>5 cm) (HR: 1.612, 95% CI: 1.087–2.390) and perineural invasion (PNI) (HR: 1.562,95% CI: 1.081–2.255) were risk factors associated with recurrence. Among patients with N1 disease, only a minority (5/128, 3.9%) of patients survived with no recurrence to 5 years. Conclusion: Roughly 1 in 6 patients survived for more than 5 years with no recurrence following curative-intent resection of ICC. Among N0 patients, tumor recurrence was associated with tumor size and PNI. Only a small subset of N1 patients experienced long-term survival.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.