What prognostic factors are important for resected intrahepatic cholangiocarcinoma?

Our aim was to evaluate the predictive factors for survival and disease-free survival of patients with resected intrahepatic cholangiocarcinoma (ICC).

Between October 1994 and 2005, 97 patients with ICC underwent curative hepatic resection. The tumors in 97 patients were reviewed retrospectively to examine the prognosis of ICC.

The 1-, 3- and 5-year survival rates were 74.9%, 51.8% and 31.1%, respectively. The 1-, 3- and 5-year disease-free survival rates were 21.3%, 6.4% and 2.1%, respectively. Univariate analysis showed that tumor size, tumor number, the gross type, resection margin status, T-stage and lymph node involvement were significant prognostic factors. Multiple tumors and cancer cells in the resection margin were found in multivariate analysis to be significantly related to the prognosis. In the multivariate analysis disease free survival was poor for the patients with a large tumor, multiple lesions, a high CA 19-9 level, cancer in the resection margin, advanced T-stage and lymph node involvement.

The overall 5-year survival rate of ICC was 31.1%. Multiple intrahepatic lesions were a sign of a poor prognosis for ICC. Better survival could be achieved by curative resection with a tumor-free margin.