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Implications of Intrahepatic Cholangiocarcinoma Etiology on Recurrence and Prognosis after Curative-Intent Resection: a Multi-Institutional Study

2018-03Journal article Open access
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dc.contributor.authorZhang, XF
dc.contributor.authorChakedis, J
dc.contributor.authorBagante, F
dc.contributor.authorBeal, EW
dc.contributor.authorLv, Y
dc.contributor.authorWeiss, M
dc.contributor.authorPopescu, I
dc.contributor.authorPinto Marques, H
dc.contributor.authorAldrighetti, L
dc.contributor.authorMaithel, SK
dc.contributor.authorPulitano, C
dc.contributor.authorBauer, TW
dc.contributor.authorShen, F
dc.contributor.authorPoultsides, GA
dc.contributor.authorSoubrane, O
dc.contributor.authorMartel, G
dc.contributor.authorGroot Koerkamp, B
dc.contributor.authorGuglielmi, A
dc.contributor.authorItaru, E
dc.contributor.authorPawlik, TM
dc.date.accessioned2018-03-02T15:57:28Z
dc.date.available2018-03-02T15:57:28Z
dc.date.issued2018-03
dc.description.abstractBACKGROUND: We sought to investigate the prognosis of patients following curative-intent surgery for intrahepatic cholangiocarcinoma (ICC) stratified by hepatitis B (HBV-ICC), hepatolithiasis (Stone-ICC), and no identifiable cause (conventional ICC) etiologic subtype. METHODS: 986 patients with HBV-ICC (n = 201), stone-ICC (n = 103), and conventional ICC (n = 682) who underwent curative-intent resection were identified from a multi-institutional database. Propensity score matching (PSM) was used to mitigate residual bias. RESULTS: HBV-ICC patients more often had cirrhosis, earlier stage tumors, a mass-forming lesion, well-to-moderate tumor differentiation, and an R0 resection versus stone-ICC or conventional ICC patients. Five-year recurrence-free survival among HBV-ICC and conventional ICC patients was 23.9 and 17.8%, respectively, versus a recurrence-free of only 8.3% among patients with stone-ICC. Similarly, 5-year overall survival among patients with stone-ICC was only 18.3% compared with 48.9 and 38.0% for patients with HBV-ICC and conventional ICC, respectively. On PSM, patients with stone-ICC group had equivalent long-term outcomes as HBV-ICC patients. In contrast, on PSM, stone-ICC patients had a median overall survival of only 18.0 months versus 44.0 months for patients with conventional ICC. Median overall survival after intrahepatic-only recurrence among patients who had stone-ICC (6.0 months) was worse than OS among HBV-ICC (13.0 months) or conventional ICC (12.0 months) (p = 0.006 and p = 0.082, respectively). CONCLUSIONS: While HBV-ICC had a better prognosis on unadjusted analyses, these differences were mitigated on PSM suggesting no stage-for-stage differences in outcomes compared with stone-ICC or conventional ICC. In contrast, patients with stone-ICC had worse long-term outcomes. These data highlight the relative importance of ICC etiology relative to established clinicopathological factors in the prognosis of patients with ICC.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationWorld J Surg. 2018 Mar;42(3):849-857pt_PT
dc.identifier.doi10.1007/s00268-017-4199-9pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/2928
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSpringer Verlagpt_PT
dc.subjectHCC CIRpt_PT
dc.subjectBile Duct Neoplasms/etiologypt_PT
dc.subjectBile Duct Neoplasms/mortalitypt_PT
dc.subjectBile Duct Neoplasms/surgerypt_PT
dc.subjectBile Ducts, Intrahepatic/surgery
dc.subjectCholangiocarcinoma/etiology
dc.subjectCholangiocarcinoma/mortality
dc.subjectCholangiocarcinoma/surgery
dc.subjectDatabases, Factual
dc.subjectFollow-Up Studies
dc.subjectNeoplasm Recurrence, Local/etiology
dc.subjectNeoplasm Recurrence, Local/mortality
dc.subjectPrognosis
dc.subjectPropensity Score
dc.subjectRisk Factors
dc.subjectSurvival Analysis
dc.titleImplications of Intrahepatic Cholangiocarcinoma Etiology on Recurrence and Prognosis after Curative-Intent Resection: a Multi-Institutional Studypt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage857pt_PT
oaire.citation.issue3pt_PT
oaire.citation.startPage849pt_PT
oaire.citation.titleWorld Journal of Surgerypt_PT
oaire.citation.volume42pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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