Prognosis after resection for hepatitis B virus-associated intrahepatic cholangiocarcinoma

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%

AFP: Alpha-fetoprotein; CA19-9: Carbohydrate antigen 19-9; MF: Mass-forming; PI: Periductal infiltrating; IG: Intraductal growth; TNM: Tumor-node-metastasis; NA: Not available; HR: Hazard ratio; LN: Lymph node.

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%

AFP: Alpha-fetoprotein; CA19-9: Carbohydrate antigen 19-9; MF: Mass-forming; PI: Periductal infiltrating; IG: Intraductal growth; TNM: Tumor-node-metastasis; NA: Not available; HR: Hazard ratio; LN: Lymph node.

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

MF: Mass-forming; PI: Periductal infiltrating; IG: Intraductal growth; LN: Lymph node; LND: Lymph node dissection; NA: Not available.