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Defining Long-Term Survivors Following Resection of Intrahepatic Cholangiocarcinoma

2017-11Journal article Open access
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dc.contributor.authorBagante, F
dc.contributor.authorSpolverato, G
dc.contributor.authorWeiss, M
dc.contributor.authorAlexandrescu, S
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.accessioned2018-03-02T15:52:50Z
dc.date.available2018-03-02T15:52:50Z
dc.date.issued2017-11
dc.description.abstractBACKGROUND: Intrahepatic cholangiocarcinoma (ICC) is an aggressive primary tumor of the liver. While surgery remains the cornerstone of therapy, long-term survival following curative-intent resection is generally poor. The aim of the current study was to define the incidence of actual long-term survivors, as well as identify clinicopathological factors associated with long-term survival. METHODS: Patients who underwent a curative-intent liver resection for ICC between 1990 and 2015 were identified using a multi-institutional database. Overall, 679 patients were alive with ≥ 5 years of follow-up or had died during follow-up. Prognostic factors among patients who were long-term survivors (LT) (overall survival (OS) ≥ 5) were compared with patients who were not non-long-term survivors (non-LT) (OS < 5). RESULTS: Among the 1154 patients who underwent liver resection for ICC, 5- and 10-year OS were 39.6 and 20.3% while the actual LT survival rate was 13.3%. After excluding 475 patients who survived < 5 years, as well as patients were alive yet had < 5 years of follow-up, 153 patients (22.5%) who survived ≥ 5 years were included in the LT group, while 526 patients (77.5%) who died < 5 years from the date of surgery were included in the non-LT group. Factors associated with not surviving to 5 years included perineural invasion (OR 4.78, 95% CI, 1.92-11.8; p = 0.001), intrahepatic metastasis (OR 3.75, 95% CI, 0.85-16.6, p = 0.082), satellite lesions (OR 2.12, 95% CI, 1.15-3.90, p = 0.016), N1 status (OR 4.64, 95% CI, 1.77-12.2; p = 0.002), ICC > 5 cm (OR 2.40, 95% CI, 1.54-3.74, p < 0.001), and direct invasion of an adjacent organ (OR 3.98, 95% CI, 1.18-13.4, p = 0.026). However, a subset of patients (< 10%) who had these pathological characteristics were LT. CONCLUSION: While ICC is generally associated with a poor prognosis, some patients will be LT. In fact, even a subset of patients with traditional adverse prognostic factors survived long term.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationJ Gastrointest Surg. 2017 Nov;21(11):1888-1897pt_PT
dc.identifier.doi10.1007/s11605-017-3550-7pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/2927
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSpringer Verlagpt_PT
dc.subjectHCC CIRpt_PT
dc.subjectBile Duct Neoplasms/mortalitypt_PT
dc.subjectBile Duct Neoplasms/pathologypt_PT
dc.subjectBile Duct Neoplasms/surgerypt_PT
dc.subjectBile Ducts, Intrahepatic/surgerypt_PT
dc.subjectCancer Survivors
dc.subjectCholangiocarcinoma/mortality
dc.subjectCholangiocarcinoma/pathology
dc.subjectCholangiocarcinoma/surgery
dc.subjectHepatectomy
dc.subjectLiver Neoplasms/secondary
dc.subjectNeoplasm Invasiveness
dc.subjectSurvival Rate
dc.titleDefining Long-Term Survivors Following Resection of Intrahepatic Cholangiocarcinomapt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage1897pt_PT
oaire.citation.issue11pt_PT
oaire.citation.startPage1888pt_PT
oaire.citation.titleJournal of Gastrointestinal Surgerypt_PT
oaire.citation.volume21pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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