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Recurrence Patterns and Timing Courses Following Curative-Intent Resection for Intrahepatic Cholangiocarcinoma

2019-08Journal article Open access
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dc.contributor.authorHu, LS
dc.contributor.authorZhang, XF
dc.contributor.authorWeiss, M
dc.contributor.authorPopescu, I
dc.contributor.authorPinto Marques, H
dc.contributor.authorAldrighetti, L
dc.contributor.authorMaithel, S
dc.contributor.authorPulitano, C
dc.contributor.authorBauer, T
dc.contributor.authorShen, F
dc.contributor.authorPoultsides, GA
dc.contributor.authorSoubrane, O
dc.contributor.authorMartel, G
dc.contributor.authorKoerkamp, B
dc.contributor.authorItaru, E
dc.contributor.authorPawlik, T
dc.date.accessioned2021-04-15T14:58:59Z
dc.date.available2021-04-15T14:58:59Z
dc.date.issued2019-08
dc.description.abstractBackground: Recurrence of intrahepatic cholangiocarcinoma (ICC) after curative resection is common. Objective: The aim of this study was to investigate the patterns, timing and risk factors of disease recurrence after curative-intent resection for ICC. Methods: Patients undergoing curative resection for ICC were identified from a multi-institutional database. Data on clinicopathological and initial operation information, timing and first sites of recurrence, recurrence management, and long-term outcomes were analyzed. Results: A total of 920 patients were included. With a median follow-up of 38 months, 607 patients (66.0%) experienced ICC recurrence. In the cohort, 145 patients (23.9%) recurred at the surgical margin, 178 (29.3%) recurred within the liver away from the surgical margin, 90 (14.8%) recurred at extraheptatic sites, and 194 (32.0%) developed both intrahepatic and extrahepatic recurrence. Intrahepatic margin recurrence (median 6.0 m) and extrahepatic-only recurrence (median 8.0 m) tended to occur early, while intrahepatic recurrence at non-margin sites occurred later (median 14.0 m; p < 0.05). On multivariate analysis, surgical margin < 10 mm was associated with increased margin recurrence (hazard ratio [HR] 1.70, 95% confidence interval [CI] 1.11-2.60; p = 0.014), whereas female sex (HR 2.12, 95% CI 1.40-3.22; p < 0.001) and liver cirrhosis (HR 2.36, 95% CI 1.31-4.25; p = 0.004) were both associated with an increased risk of intrahepatic recurrence at other sites. Median survival after recurrence was better among patients who underwent repeat curative-intent surgery (48.7 months) versus other treatments (9.7 months) [p < 0.001]. Conclusions: Different recurrence patterns and timing of recurrence suggest biological heterogeneity of ICC tumor recurrence. Understanding timing and risk factors associated with different types of recurrence can hopefully inform discussions around adjuvant therapy, surveillance, and treatment of recurrent disease.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationAnn Surg Oncol. 2019 Aug;26(8):2549-2557.pt_PT
dc.identifier.doi10.1245/s10434-019-07353-4pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/3661
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSpringerpt_PT
dc.subjectAgedpt_PT
dc.subjectBile Duct Neoplasmspt_PT
dc.subjectCholangiocarcinomapt_PT
dc.subjectDatabases, Factualpt_PT
dc.subjectFemalept_PT
dc.subjectFollow-Up Studiespt_PT
dc.subjectHepatectomypt_PT
dc.subjectHumanspt_PT
dc.subjectIncidencept_PT
dc.subjectMalept_PT
dc.subjectMiddle Agedpt_PT
dc.subjectNeoplasm Invasivenesspt_PT
dc.subjectNeoplasm Recurrence, Localpt_PT
dc.subjectPrognosispt_PT
dc.subjectRetrospective Studiespt_PT
dc.subjectRisk Factorspt_PT
dc.subjectSurvival Ratept_PT
dc.subjectMargins of Excisionpt_PT
dc.subjectHCC CIRpt_PT
dc.titleRecurrence Patterns and Timing Courses Following Curative-Intent Resection for Intrahepatic Cholangiocarcinomapt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage2557pt_PT
oaire.citation.issue8pt_PT
oaire.citation.startPage2549pt_PT
oaire.citation.titleAnnals of Surgical Oncologypt_PT
oaire.citation.volume26pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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