Intrahepatic Cholangiocarcinoma Surgery Outcomes and Survival Factors in an Opisthorchis viverrini -Endemic Area
Nisit Tongsiri1, Rawin Ingsirorat2
1Department of Surgery, Sakon Nakhon Hospital, Ministry of Public Health, Sakon Nakhon, Sakon Nakhon Province, Thailand.
Background:
Cholangiocarcinoma (CCA) is a malignancy of the bile duct epithelium. Its incidence is highest in Northeast Thailand, where it is strongly associated with Opisthorchis viverrini (OV) infection. The only curative treatment for intrahepatic cholangiocarcinoma (IHCCA), the most common subtype, is surgical resection. This study aimed to investigate survival outcomes and identify factors associated with long-term survival in resectable IHCCA patients in the high-incidence of OV infection.
Methods:
This retrospective cohort study included all patients who underwent curative-intent hepatic resection for pathologically confirmed IHCCA at Sakon Nakhon Hospital between January 2016 and December 2023. Survival was analysed using Kaplan-Meier method. Univariate and multivariate Cox proportional hazard regression models were used to identify prognosis factors.
Results:
A total of 63 patients were included. The 30-day and 90-day mortality rate were 1.6% and 6.3%, respectively. The median overall survival was 28.5 months (95% CI: 13.79-43.13). The 1-year, 3-year, and 5-year survival rates were 71.1%, 43.5%, and 30.1%, respectively. In the multivariate analysis, factors significantly associated with poorer survival were advanced disease (Stages III and IV) (adjusted hazard ratios [aHR] = 3.37; 95% CI: 1.63-6.97) and lymphovascular invasion (LVI) (aHR = 2.55; 95% CI: 1.27-5.11).
Conclusion:
The median survival and 5-year survival in this study are consistent with outcomes from previous studies. Advanced disease stage and the presence of LVI are independent predictors of poor survival.
