Clinical Analysis of Intrahepatic Cholangiocarcinoma

Kang, Kwang Sung; Kim, Ki Ho; Suh, Kyung Suk; Kim, Sun Whe; Lee, Kuhn Uk

Abstract

BACKGROUND AND AIMS: Patients with an intrahepatic cholangiocarcinoma are faced with an extremely poor prognosis due to late diagnosis and low resectability. The purpose of this study is to define the clinical characteristics of and evaluate the outcomes for intrahepatic cholangiocarcinoma.
METHODS
AND METERIALS: To evaluate the clinicopathologic characteristics and the value of surgical management in relation to survival, we retrospectively reviewed the clinical records of 53 patients with an intrahepatic cholangiocarcinoma who had been treated at the department of Surgery, Seoul National University College of Medicine, from Jan. 1991 to Dec. 1995. Survival was calculated using the method of Kaplan-Meier, and differences between survival rates were analyzed with the log-rank test.
RESULTS
Forty-three of the 53 patients were treated surgically, with 21 undergoing a curative hepatic resection and 22 patients undergoing a palliative procedure. Ten patients had distant metastasis and were treated by conservative methods only. The log-rank test revealed that patients undergoing curative a hepatic resection had significantly better survival as compared to the palliative and the conservative groups. However, no significant difference in survival existed between the palliative group and the conservative group. The survival rate and the resectability correlated with the TNM stage. In the curative resection group, there were no significant factors related to survival.
CONCLUSION
The curative hepatic resection seems to provide the only chance for therapeutic success in patients with an intrahepatic cholangiocarcinoma. Palliative or nonsurgical therapeutic modalities are not effective. A curative hepatic resection is possible when the tumor is detected in an early stage.