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Published on: January 17, 2025
684
Surgery for Multifocal Intrahepatic Cholangiocarcinoma
Augustė Andzelytė1, Ieva Tveragaitė1, Povilas Ignatavicius2,3
1Faculty of Medicine, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Digestive Surgery
|September 18, 2025
Summary
Surgical resection for multifocal intrahepatic cholangiocarcinoma (m-iCCA) offers survival benefits despite high recurrence rates. Careful patient selection is crucial for improving outcomes in this aggressive liver cancer.
Area of Science:
- Hepatobiliary Surgery
- Surgical Oncology
- Gastroenterology
Background:
- Multifocal intrahepatic cholangiocarcinoma (m-iCCA) is an aggressive liver cancer with poor prognosis.
- Surgical resection is the only curative option, but multifocality often precludes surgery due to high recurrence risks.
Purpose of the Study:
- To systematically review surgical treatment outcomes for m-iCCA.
- To evaluate the feasibility and survival benefits of surgical resection in m-iCCA patients.
Main Methods:
- Systematic review following PRISMA guidelines.
- Searched PubMed, Web of Science, MEDLINE, and ScienceDirect databases.
- Included 10 studies with 2,392 m-iCCA patients; assessed quality using Newcastle-Ottawa Scale.
Main Results:
- Median survival ranged from 18.9 to 27 months with extensive surgical procedures.
- Recurrence rates were higher in m-iCCA (67.8-74.3%) versus solitary iCCA (52.4-60.5%).
- Adverse prognostic indicators like lymph node metastases impacted survival; 5-year survival was 12.9% for surgical vs. 0% for non-surgical patients.
Conclusions:
- Surgical resection for m-iCCA, despite high recurrence, offers a survival advantage over non-surgical management.
- Careful patient selection is essential to improve long-term outcomes.
- Further research is needed to refine selection criteria and treatment strategies.
