An intraductal papillary component is associated with prolonged survival after hepatic resection for intrahepatic cholangiocarcinoma

Abstract

Background The outcome after surgery for intrahepatic cholangiocarcinoma (ICC) is dismal and data on long-term survival are not available. This study evaluated prognostic indicators and characteristic features of long-term survivors after hepatic resection for ICC. Methods Thirty-one patients who had undergone hepatic resection for ICC were studied. Univariate and multivariate survival analyses of clinicopathological data included an intraductal papillary carcinoma component (IDPCC) in the tumour, which was defined as the histological demonstration of cancer cells growing in a papillary fashion into the lumen of the large bile duct. Results The overall cumulative survival rate after hepatic resection for ICC was 51·2 per cent at 1 year and 24·5 per cent at 5 years, with a mean(s.d.) survival time of 11(4) months. The presence of IDPCC (P = 0·003), curative resection (P = 0·009) and the absence of perineural invasion (P = 0·040) were identified as favourable independent prognostic factors in multivariate analysis. Eight patients with IDPCC had a 5-year survival rate of 87·5 per cent and a mean(s.d.) survival time of 69(13) months. All seven patients who survived for more than 5 years after surgery had IDPCC, regardless of the gross appearance of the tumour. Conclusion An IDPCC in the tumour resulted in long-term survival after hepatic resection for ICC.