A Clinical Review for Resected Intrahepatic Cholangiocarcinoma

Hong, Seong Kweon; Kim, Han Joon; Choi, Dongho; Lee, Kyeong Geun; Park, Hwon Kyum; Paik, Seung Sam; Lee, Kwang Soo

Abstract

BACKGROUND/AIMS: An intrahepatic cholangiocarcinoma, which has been defined as a primary adenocarcinoma from the intrahepatic bile duct to the second-order branch of the main hepatic duct, has a poor prognosis due to late diagnosis and low resectability. The purpose of this study is to define the prognostic factors that affected the survival of patients.
METHODS
To evaluate the clinical manifestation and pathologic characteristics and the value of surgical management in relation to survival, we retrospectively reviewed the clinical records of 37 patients with an intrahepatic cholangiocarcinoma who had been underwent hepatic resection at the department of surgery, Hanyang University Hospital from April 1986 to April 2001. Cumulative survival rate and clinicopa-thologic factors that may influence the prognosis were analyzed statistically. Statistical significance was calculated by the Kaplan-Meier and compared by log rank test with statistical significance defined as p<0.05.
RESULTS
The median survival time of the patients was 24.6 months (mean, 23.97 months), with 2 and 3-year survival rates of 33.3% and 27.3%, respectively. Univariate analysis showed that TMN stage and gross type correlated significantly with prognosis. Age, sex, tumor marker, Clonorchis Sinensis, intrahepatic duct stone and cell differentiation were not significantly correlated with prognosis.
CONCLUSION
In case of the intrahepatic cholangiocarcinoma, without surgical treatment, survival time is not longer than mean 6 months from the first diagnosis. According to this study, we strongly recommend to early diagnosis and proper hepatic resection with lymph node dissection, be recommended to raise the long-term survival rate and improve the quality of life.