Wu ZF, Wu XY, Zhu N, Xu Z, Li WS, Zhang HB, Yang N, Yao XQ, Liu FK, Yang GS. Prognosis after resection for hepatitis B virus-associated intrahepatic cholangiocarcinoma. World J Gastroenterol 2015; 21(3): 935-943 [PMID: 25624728 DOI: 10.3748/wjg.v21.i3.935]
Corresponding Author of This Article
Xue-Quan Yao, MD, Department of Surgical Oncology, Jiangsu Province Hospital of Traditional Chinese Medicine, the Affiliated Hospital of Nanjing University of Chinese Medicine, No. 155 Hanzhong Road, Nanjing 210029, Jiangsu Province, China. xuequan000@126.com
Research Domain of This Article
Surgery
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
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World J Gastroenterol. Jan 21, 2015; 21(3): 935-943 Published online Jan 21, 2015. doi: 10.3748/wjg.v21.i3.935
Table 1 Operative procedures for intrahepatic cholangiocarcinoma
Operative modality
Number
Hepatic resection (n = 85)
Major resection (n = 40)
Partial hepatectomy
24
Right trisectionectomy
1
Left trisectionectomy
4
Right hemihepatectomy
1
Left hemihepatectomy
8
Central bisectionectomy
2
Minor resection (n = 45)
Partial hepatectomy
33
Right anterior sectionectomy
2
Right posterior sectionectomy
3
Left lateral sectionectomy
4
Bisegmentectomy
3
Combined resection (n = 10)
Spleen
2
Gallbladder
8
Table 2 Univariate and multivariate analyses of prognostic factors for overall survival of hepatitis B virus-associated intrahepatic cholangiocarcinoma patients included in this study
Variable
n
Univariate analysis
Multivariateanalyses
1-yr
5-yr
P value
HR
95%CI
P value
Gender
0.205
NA
NA
NA
Female
19
66%
23%
Male
66
58%
10%
Age
0.769
NA
NA
NA
≤ 60
59
64%
13%
> 60
26
50%
12%
Capsule formation
0.522
NA
NA
NA
Yes
32
55%
10%
No
53
63%
14%
Cirrhosis
0.002
1.981
1.197-3.278
0.008
Yes
48
56%
0%
No
37
65%
27%
Child-Pugh class
0.257
NA
NA
NA
A
76
61%
14%
B
9
18%
0%
AFP (ng/mL)
0.342
NA
NA
NA
≤ 20
48
51%
11%
> 20
37
72%
15%
CA19-9 (U/mL)
0.342
NA
NA
NA
≤ 37
55
66%
14%
> 37
30
50%
10%
Gross type
0.402
NA
NA
NA
MF
63
61%
13%
PI + IG
22
56%
11%
Differentiation
0.119
NA
NA
NA
Well or Moderate
63
64%
16%
Poor
22
50%
0%
Tumor number
< 0.001
2.653
1.562-4.508
< 0.001
Single
60
69%
17%
Multiple
25
38%
0%
Tumor size
0.006
NA
NA
NA
< 5 cm
43
70%
21%
≥ 5 cm
42
49%
5%
LN metastasis
0.005
NA
NA
NA
Yes
11
31%
0%
No
74
64%
14%
Vascular invasion
0.013
NA
NA
NA
Yes
11
24%
0%
No
74
64%
14%
TNM classification
< 0.001
NA
NA
NA
Stage I or II
61
66%
17%
Stage III or IV
24
43%
0%
Width of resection margin
0.274
NA
NA
NA
< 1 cm
37
69%
17%
≥ 1 cm
48
53%
9%
Surgical procedure
0.962
NA
NA
NA
Major hepatectomy
40
61%
13%
Minor hepatectomy
45
59%
12%
Table 3 Sites of initial recurrences in hepatitis B virus-associated intrahepatic cholangiocarcinoma patients after curative resection
Site of initial recurrence
No. of patients
Liver, lymph nodes
6
Liver, lung
1
Liver
46
Lymph nodes
8
Peritoneum
5
Wound site
1
Bone
1
Lung
2
Table 4 Univariate and multivariate analyses of prognostic factors for disease-free survival in hepatitis B virus-associated intrahepatic cholangiocarcinoma patients included in this study
Variable
n
Univariate analysis
Multivariateanalyses
1-yr
5-yr
P value
HR
95%CI
P value
Gender
0.312
NA
NA
NA
Female
19
50%
0%
Male
66
32%
4%
Age
0.853
NA
NA
NA
≤ 60
59
33%
1%
> 60
26
42%
5%
Capsule formation
0.970
NA
NA
NA
Yes
32
40%
7%
No
53
33%
0%
Cirrhosis
0.003
1.919
1.153-3.192
0.012
Yes
48
22%
0%
No
37
52%
5%
Child-Pugh class
0.237
NA
NA
NA
A
76
50%
20%
B
9
27%
0%
AFP (ng/mL)
0.648
NA
NA
NA
≤ 20
48
32%
3%
> 20
37
40%
2%
CA19-9 (U/mL)
0.189
NA
NA
NA
≤ 37
55
39%
3%
> 37
30
29%
2%
Gross type
0.917
NA
NA
NA
MF
63
37%
3%
PI + IG
22
30%
0%
Differentiation
0.076
NA
NA
NA
Well or Moderate
63
42%
3%
Poor
22
18%
0%
Tumor number
< 0.001
NA
NA
NA
Single
60
48%
3%
Multiple
25
5%
0%
Tumor size
0.091
NA
NA
NA
< 5 cm
43
44%
1%
≥ 5 cm
42
27%
5%
LN metastasis
< 0.001
NA
NA
NA
Yes
11
0%
0%
No
74
40%
3%
Vascular invasion
3.779
1.601-8.923
0.020
Yes
11
No
74
TNM classification
< 0.001
NA
NA
NA
Stage I or II
61
0%
0%
Stage III or IV
24
51%
20%
Width of resection margin
< 0.001
NA
NA
NA
< 1 cm
37
49%
4%
≥ 1 cm
48
0%
0%
Surgical procedure
0.391
NA
NA
NA
Major hepatectomy
40
41%
2%
Minor hepatectomy
45
31%
3%
Table 5 Comparison of the pathological factors according to the extent of lymph node dissection
Variable
LND (-)
LN sampling
Regional LND
P value
Cirrhosis
0.439
Yes
17
13
18
No
18
9
10
Gross type
0.617
MF
24
17
22
PI + IG
11
5
6
Differentiation
0.478
Well or Moderate
25
15
23
Poor
10
7
5
Capsule formation
0.931
Yes
14
8
10
No
21
14
18
Tumor number
0.512
Single
27
14
18
Multiple
8
8
10
Tumor size
0.145
< 5 cm
21
12
10
≥ 5 cm
14
10
18
Pathologica LN metastasis
0.085
Yes
NA
2
9
No
NA
20
19
Vascular invasion
0.181
Yes
2
3
6
No
33
19
22
Citation: Wu ZF, Wu XY, Zhu N, Xu Z, Li WS, Zhang HB, Yang N, Yao XQ, Liu FK, Yang GS. Prognosis after resection for hepatitis B virus-associated intrahepatic cholangiocarcinoma. World J Gastroenterol 2015; 21(3): 935-943