Utilize este identificador para referenciar este registo: http://hdl.handle.net/10400.17/1291
Título: Recurrence After Operative Management of Intrahepatic Cholangiocarcinoma
Autor: Hyder, O
Hatzaras, I
Sotiropoulos, G
Paul, A
Alexandrescu, S
Marques, H
Pulitano, C
Barroso, E
Clary, B
Aldrighetti, L
Ferrone, C
Zhu, A
Bauer, T
Walters, D
Groeschl, R
Gamblin, C
Marsh, J
Nguyen, K
Turley, R
Popescu, I
Hubert, C
Meyer, S
Choti, M
Gigot, JF
Mentha, G
Pawlik, T
Palavras-chave: Colangiocarcinoma
Neoplasias das Vias Biliares
Vias Biliares Intra-Hepáticas
Sobrevivência Livre de Doença
Estimativa de Kaplan-Meier
Neoplasias Hepáticas
Metástases Linfáticas
Invasão Neoplásica
Factores de Risco
Recidiva Neoplásica Local
Data: 2013
Editora: Elsevier
Citação: Surgery. 2013 Jun;153(6):811-8
Resumo: INTRODUCTION: Data on recurrence after operation for intrahepatic cholangiocarcinoma (ICC) are limited. We sought to investigate rates and patterns of recurrence in patients after operative intervention for ICC. METHODS: We identified 301 patients who underwent operation for ICC between 1990 and 2011 from an international, multi-institutional database. Clinicopathologic data, recurrence patterns, and recurrence-free survival (RFS) were analyzed. RESULTS: During the median follow up duration of 31 months (range 1-208), 53.5% developed a recurrence. Median RFS was 20.2 months and 5-year actuarial disease-free survival, 32.1%. The most common site for initial recurrence after operation of ICC was intrahepatic (n = 98; 60.9%), followed by simultaneous intra- and extrahepatic disease (n = 30; 18.6%); 33 (21.0%) patients developed extrahepatic recurrence only as the first site of recurrence. Macrovascular invasion (hazard ratio [HR], 2.08; 95% confidence interval [CI], 1.34-3.21; P < .001), nodal metastasis (HR, 1.55; 95% CI, 1.01-2.45; P = .04), unknown nodal status (HR, 1.57; 95% CI, 1.10-2.25; P = .04), and tumor size ≥5 cm (HR, 1.84; 95% CI, 1.28-2.65; P < .001) were independently associated with increased risk of recurrence. Patients were assigned a clinical score from 0 to 3 according to the presence of these risk factors. The 5-year RFS for patients with scores of 0, 1, 2, and 3 was 61.8%, 36.2%, 19.5%, and 9.6%, respectively. CONCLUSION: Recurrence after operative intervention for ICC was common. Disease recurred both at intra- and extrahepatic sites with roughly the same frequency. Factors such as lymph node metastasis, tumor size, and vascular invasion predict highest risk of recurrence.
Peer review: yes
URI: http://hdl.handle.net/10400.17/1291
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