Factors Related to Post-operative Recurrence of Intrahepatic Cholangiocarcinoma
Wikran Suragul MD*, Narongsak Rungsakulkij MD*, Paramin Muangkaew MD*, Pongsatorn Tangtawee MD*, Somkit Mingphruedhi MD*
Affiliation : * Division of Hepato-Pancreato-Biliary Surgery, Department of Surgery, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Background : An incidence of intrahepatic cholangiocarcinoma (ICC) is high in Thailand and rising worldwide. Because of
a dismal prognosis and a high recurrence rate after surgery.
Objective : To identify influential factors of cancer recurrence after liver resection.
Material and Method: A retrospective chart review was carried out in 66 patients who underwent R0 and R1 resection for
ICC between 2002 and 2014 at Ramathibodi Hospital. Demographics data, pathological results and long term outcome were
collected. Univariate and multivariate analysis were conducted to assess the risk factors of tumor recurrence.
Results : The median follow-up time was 18 months (range: 2 to 123 months), most of the patients experienced cancer
recurrence in first year after surgery. The median time to recurrence was 9 months (range: 6.0 to 14.0), 5-year recurrence
free survival (RFS) was 16.67%. The most common site of recurrence was the liver, followed by the lymph node. The most
common pattern of recurrence was simultaneous intra- and extra-hepatic. The independent risk factor of the tumor recurrence
after liver resection was tumor size >10 cm (HR, 2.804; 95% CI, 1.24 to 6.32; p = 0.013).
Conclusion : Large tumor size was the bad prognostic factor in ICC patients resulting in great risk of recurrence.
Keywords : Intrahepatic cholangiocarcinoma, Post-operative recurrence
