Liver Resection for Intrahepatic Cholangiocarcinoma: Clinical Outcomes and Prognostic Factors in a Series of 1842 Patients at a Single Center

Currently, the only available curative treatment for intrahepatic cholangiocarcinoma (ICC) is surgical resection, but the survival outcomes are still disappointing. This study aimed to present the surgical outcomes of a large series of ICC patients and investigate the prognostic factors for recurrence and survival. From January 2003 to December 2013, a series of consecutive patients with ICC who underwent curative-intent resection were enrolled. Historical patient records and follow-up results were collected and analyzed. A total of 1842 patients were included in the study, of which 328 (17.8%) experienced complications after surgery with a mortality of 0.3%. The overall survival rates of the entire cohort at 1, 3, and 5 years were 72.5%, 46.9%, and 37.3%, respectively, while the disease-free survival rates at 1, 3, and 5 years were 55.8%, 39.0%, and 23.7%, respectively. Elevated alpha-fetoprotein level, elevated carbohydrate antigen 19–9 level, tumor size > 10 cm, lymphadenectomy, positive lymph node, macrovascular invasion, microvascular invasion, and adjuvant transarterial chemoembolization after surgery were independent predictors for recurrence, while hepatolithiasis, viral hepatitis, elevated carbohydrate antigen 19–9 level, tumor size > 10 cm, lymphadenectomy, positive lymph node, and macrovascular and microvascular invasion were independent prognostic factors for overall survival. Liver resection is safe to treat ICC even when combined with lymphadenectomy. Adequate regional lymphadenectomy should be recommended for all resectable ICC patients to obtain final pathological examination which is essential for predicting recurrence and survival.