Actual over 10-year survival after liver resection for patients with intrahepatic cholangiocarcinoma

// Anfeng Si 1, * , Jun Li 1, * , Hongjun Xiang 1, 2, * , Shichao Zhang 1 , Shilei Bai 1 , Pinghua Yang 3 , Xiaofeng Zhang 1 , Yong Xia 1, 4 , Kui Wang 5 , Zhenlin Yan 1 , Wan Yee Lau 1, 6 , Lehua Shi 1 and Feng Shen 1 1 Department of Hepatic Surgery IV, The Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China 2 Department of Hepatobiliary Surgery, The Lanzhou General Hospital of People's Liberation Army, Gansu, China 3 Department of Minimally Invasive Surgery, The Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China 4 Department of Clinical Database, The Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China 5 Department of Hepatic Surgery II, The Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China 6 Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China * These authors have contributed equally to this work Correspondence to: Feng Shen, email: shenfengehbh@sina.com Keywords: intrahepatic cholangiocarcinoma, liver resection, long-term outcome, 10-year, actual survivors Received: November 30, 2016 Accepted: April 27, 2017 Published: May 11, 2017 ABSTRACT Partial hepatectomy is a potentially curative therapy for intrahepatic cholangiocarcinoma (ICC). Unfortunately, the overall surgical prognosis remains dismal and the actual 10-year survival has not been reported. This study aimed to document 10-year actual survival rates, identify the prognostic factors associated with 10-year survival rate, and analyze the characteristics of patients who survived ≥ 10 years. Among 251 patients who underwent curative liver resection for ICC between 2003 and 2006 at the Eastern Hepatobiliary Surgery Hospital, 21 patients (8.4%) survived ≥ 10 years. The 5-, 7-, and 10-year overall survival rates were 32.3%, 22.3% and 8.4%, respectively. The 10-year cumulative incidence of ICC-related death and recurrence were 80.9% and 85.7%, respectively. Multivariate analysis based on competing risk survival analysis identified that tumor > 5 cm was independently associated with ICC-related death and recurrence (hazard ratios: 1.369 and 1.445, respectively), in addition to carcinoembryonic antigen (CEA) >10 U/mL, carbohydrate antigen 19-9 (CA19-9) >39 U/mL, multiple nodules, vascular invasion, nodal metastasis and local extrahepatic invasion. Patients who survived ≥ 10 years had a longer time to first recurrence, lower levels of CEA, CA19-9 and alkaline phosphatase, less perioperative blood loss, solitary tumor, smaller tumor size, and absence of nodal metastasis or local extrahepatic invasion. In conclusion, a 10-year survival after liver resection for ICC is possible and can be expected in approximately 8.4% of patients.