Prognostic factors of recurrent intrahepatic cholangiocarcinoma after hepatectomy: A retrospective study

doi:10.3748/wjg.v28.i15.1574

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World Journal of Gastroenterology

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Retrospective Study

World J Gastroenterol. Apr 21, 2022; 28(15): 1574-1587
Published online Apr 21, 2022. doi: 10.3748/wjg.v28.i15.1574

Prognostic factors of recurrent intrahepatic cholangiocarcinoma after hepatectomy: A retrospective study

Zi-Bo Yuan, Hong-Bo Fang, Quan-Kai Feng, Tao Li, Jie Li

Zi-Bo Yuan, Hong-Bo Fang, Quan-Kai Feng, Tao Li, Jie Li, Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China

Zi-Bo Yuan, Hong-Bo Fang, Quan-Kai Feng, Jie Li, Henan Research Centre for Organ Transplantation, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China

Author contributions: Yuan ZB contributed to collect data and draft the manuscript; Fang HB contributed to data analysis; Feng QK and Li T contributed to clinical advice and follow-up survey; Li J contributed to the conception and critically revised the manuscript; all authors read and agreed the final manuscript to be published.

Supported by Medical Science and Technology Project of Henan Province, No. SBGJ2018024.

Institutional review board statement: The study was approved by the Scientific Research and Clinical Trial Ethics Committee of the First Affiliated Hospital of Zhengzhou University.

Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.

Conflict-of-interest statement: We declare that they have no conflicting interests.

Data sharing statement: No additional data are available.

Corresponding author: Jie Li, MD, PhD, Director, Doctor, Professor, Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe Road, Zhengzhou 450052, Henan Province, China. ljljdoctor@126.com

Received: November 17, 2021
Peer-review started: November 17, 2021
First decision: January 9, 2022
Revised: January 18, 2022
Accepted: March 6, 2022
Article in press: March 6, 2022
Published online: April 21, 2022
Processing time: 148 Days and 21.1 Hours

ARTICLE HIGHLIGHTS

Research background

Intrahepatic cholangiocarcinoma (ICC) is a highly malignant tumour originating from intrahepatic bile duct epithelial cells. Recurrence is very common after hepatectomy.

Research motivation

There are few reports on the clinical features and prognostic factors of recurrent ICC, and the treatment strategies for recurrent ICC have not been fully clarified.

Research objectives

The objective of this study was to analyze the prognostic factors of recurrent ICC and to explore treatment strategies.

Research methods

We retrospectively analyzed all ICC patients who underwent hepatectomy at the First Affiliated Hospital of Zhengzhou University between January 2013 and August 2021. We summarized the clinical characteristics of patients with recurrent ICC and assessed prognostic factors by univariate and multivariate analyses.

Research results

Recurrence occurred in 54 of 103 patients with ICC after hepatectomy during the study period. The median OS of patients with recurrent ICC was 4 mo, and the cumulative OS rates at 1, 2, and 3 years after recurrence were 16.1%, 6.7%, and 3.4%, respectively. Multivariate analysis of cumulative survival by the Cox proportional risk model showed that alcohol consumption [hazard ratio (HR) = 4.64, 95% confidence interval (CI): 1.53-14.04, P = 0.007], DFS < 6 mo (HR = 3.47, 95%CI: 1.59-7.60, P = 0.002) and treatment after recurrence (HR = 0.21, 95%CI: 0.08-0.55, P = 0.001) were independent factors for recurrence. Patients who received multimodality therapy had higher survival rates than those who did not (P = 0.026).

Research conclusions

The prognosis of recurrent patients is related to alcohol consumption, DFS < 6 mo and treatment after recurrence. Active and effective multidisciplinary treatment is beneficial to improve the prognosis of patients.

Research perspectives

Multicentre prospective studies are needed to evaluate the efficacy of multidisciplinary treatment in recurrent ICC.