Prognosis after resection for hepatitis B virus-associated intrahepatic cholangiocarcinoma

AIM:To investigate the prognostic factors after resection for hepatitis B virus(HBV)-associated intrahepatic cholangiocarcinoma(ICC) and to assess the impact of different extents of lymphadenectomy on patient survival.METHODS:A total of 85 patients with HBV-associated ICC who underwent curative rese...

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Published in:World journal of gastroenterology : WJG 2015-01, Vol.21 (3), p.935-943
Main Authors: Wu, Zhen-Feng, Wu, Xiao-Yu, Zhu, Nan, Xu, Zhe, Li, Wei-Su, Zhang, Hai-Bin, Yang, Ning, Yao, Xue-Quan, Liu, Fu-Kun, Yang, Guang-Shun
Format: Article
Language:English
Subjects:
Adult
Aged
Bile Duct Neoplasms - mortality
Bile Duct Neoplasms - pathology
Bile Duct Neoplasms - surgery
Bile Duct Neoplasms - virology
Bile Ducts, Intrahepatic - pathology
Bile Ducts, Intrahepatic - surgery
Bile Ducts, Intrahepatic - virology
Chi-Square Distribution
Cholangiocarcinoma - mortality
Cholangiocarcinoma - secondary
Cholangiocarcinoma - surgery
Cholangiocarcinoma - virology
cholangiocarcinoma
Hepatitis
Disease Progression
Disease-Free Survival
Female
Hepatectomy - adverse effects
Hepatectomy - mortality
Hepatitis B - complications
Hepatitis B - diagnosis
Hepatitis B - mortality
Humans
Intrahepatic
Lymph Node Excision - adverse effects
Lymph Node Excision - mortality
Lymphatic Metastasis
Male
Middle Aged
Multivariate Analysis
Neoplasm Recurrence, Local
Neoplasm Staging
Patient Selection
Proportional Hazards Models
Retrospective Studies
Retrospective Study
Risk Factors
Time Factors
Treatment Outcome
virus
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Summary:AIM:To investigate the prognostic factors after resection for hepatitis B virus(HBV)-associated intrahepatic cholangiocarcinoma(ICC) and to assess the impact of different extents of lymphadenectomy on patient survival.METHODS:A total of 85 patients with HBV-associated ICC who underwent curative resection from January 2005 to December 2006 were analyzed.The patients were classified into groups according to the extent of lymphadenectomy(no lymph node dissection,sampling lymph node dissection and regional lymph node dissection).Clinicopathological characteristics and survival were reviewed retrospectively.RESULTS:The cumulative 1-,3-,and 5-year survival rates were found to be 60 %,18 %,and 13 %,respectively.Multivariate analysis revealed that liver cirrhosis(HR = 1.875,95%CI:1.197-3.278,P = 0.008) and multiple tumors(HR = 2.653,95%CI:1.562-4.508,P < 0.001) were independent prognostic factors for survival.Recurrence occurred in 70 patients.The 1-,3-,and 5-year disease-free survival rates were 36%,3% and 0%,respectively.Liver cirrhosis(HR = 1.919,P = 0.012),advanced TNM stage(stage Ⅲ/Ⅳ)(HR = 2.027,P < 0.001),and vascular invasion(HR = 3.779,P = 0.02) were independent prognostic factors for disease-free survival.Patients with regional lymph node dissection demonstrated a similar survival rate to patients with sampling lymph node dissection.Lymphadenectomy did not significantly improve the survival rate of patients with negative lymph node status.CONCLUSION:The extent of lymphadenectomy does not seem to have influence on the survival of patients with HBV-associated ICC,and routine lymph nodedissection is not recommended,particularly for those without lymph node metastasis.
ISSN:1007-9327
2219-2840
DOI:10.3748/wjg.v21.i3.935