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Management and Outcomes of Patients with Recurrent Intrahepatic Cholangiocarcinoma Following Previous Curative-Intent Surgical Resection

2016-01Journal article Open access
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dc.contributor.authorSpolverato, G
dc.contributor.authorKim, Y
dc.contributor.authorAlexandrescu, S
dc.contributor.authorPinto Marques, H
dc.contributor.authorLamelas, J
dc.contributor.authorAldrighetti, L
dc.contributor.authorClark Gamblin, T
dc.contributor.authorMaithel, SK
dc.contributor.authorPulitano, C
dc.contributor.authorBauer, TW
dc.contributor.authorShen, F
dc.contributor.authorPoultsides, GA
dc.contributor.authorTran, TB
dc.contributor.authorWallis Marsh, J
dc.contributor.authorPawlik, TM
dc.date.accessioned2018-07-12T15:26:48Z
dc.date.available2018-07-12T15:26:48Z
dc.date.issued2016-01
dc.description.abstractBACKGROUND: Management and outcomes of patients with recurrent intrahepatic cholangiocarcinoma (ICC) following curative-intent surgery are not well documented. We sought to characterize the treatment of patients with recurrent ICC and define therapy-specific outcomes. METHODS: Patients who underwent surgery for ICC from 1990 to 2013 were identified from an international database. Data on clinicopathological characteristics, operative details, recurrence, and recurrence-related management were recorded and analyzed. RESULTS: A total of 563 patients undergoing curative-intent hepatic resection for ICC who met the inclusion criteria were identified. With a median follow-up of 19 months, 400 (71.0 %) patients developed a recurrence. At initial surgery, treatment was resection only (98.8 %) or resection + ablation (1.2 %). Overall 5-year survival was 23.6 %; 400 (71.0 %) patients recurred with a median disease-free survival of 11.2 months. First recurrence site was intrahepatic only (59.8 %), extrahepatic only (14.5 %), or intra- and extrahepatic (25.7 %). Overall, 210 (52.5 %) patients received best supportive care (BSC), whereas 190 (47.5 %) patients received treatment, such as systemic chemotherapy-only (24.2 %) or repeat liver-directed therapy ± systemic chemotherapy (75.8 %). Repeat liver-directed therapy consisted of repeat hepatic resection ± ablation (28.5 %), ablation alone (18.7 %), and intra-arterial therapy (IAT) (52.8 %). Among patients who recurred, median survival from the time of the recurrence was 11.1 months (BSC 8.0 months, systemic chemotherapy-only 16.8 months, liver-directed therapy 18.0 months). The median survival of patients undergoing resection of recurrent ICC was 26.7 months versus 9.6 months for patients who had IAT (p < 0.001). CONCLUSIONS: Recurrence following resection of ICC was common, occurring in up to two-thirds of patients. When there is recurrence, prognosis is poor. Only 9 % of patients underwent repeat liver resection after recurrence, which offered a modest survival benefit.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationAnn Surg Oncol. 2016 Jan;23(1):235-43.pt_PT
dc.identifier.doi10.1245/s10434-015-4642-9pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/3005
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSpringer Verlagpt_PT
dc.subjectBile Duct Neoplasmspt_PT
dc.subjectCholangiocarcinomapt_PT
dc.subjectCohort Studiespt_PT
dc.subjectDisease Managementpt_PT
dc.subjectFollow-Up Studiespt_PT
dc.subjectHepatectomypt_PT
dc.subjectHumanspt_PT
dc.subjectNeoplasm Invasivenesspt_PT
dc.subjectNeoplasm Recurrence, Localpt_PT
dc.subjectNeoplasm Stagingpt_PT
dc.subjectPrognosispt_PT
dc.subjectCHLC CHBPTpt_PT
dc.titleManagement and Outcomes of Patients with Recurrent Intrahepatic Cholangiocarcinoma Following Previous Curative-Intent Surgical Resectionpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage243pt_PT
oaire.citation.issue1pt_PT
oaire.citation.startPage235pt_PT
oaire.citation.titleAnnals of Surgical Oncologypt_PT
oaire.citation.volume23pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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