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Survival after Resection of Multiple Tumor Foci of Intrahepatic Cholangiocarcinoma

BACKGROUND: Multiple tumor foci of intrahepatic cholangiocarcinoma (ICC) are often considered a contra-indication for resection. We sought to define long-term outcomes after resection of ICC in patients with multiple foci. METHODS: Patients who underwent resection for ICC between 1990 and 2017 were...

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Autores principales: Buettner, Stefan, ten Cate, David W. G., Bagante, Fabio, Alexandrescu, Sorin, Marques, Hugo P., Lamelas, Jorge, Aldrighetti, Luca, Gamblin, T. Clark, Maithel, Shishir K., Pulitano, Carlo, Margonis, Georgios Antonios, Weiss, Matthew, Bauer, Todd W., Shen, Feng, Poultsides, George A., Marsh, J. Wallis, IJzermans, Jan N. M., Pawlik, Timothy M., Koerkamp, Bas Groot
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6831534/
https://www.ncbi.nlm.nih.gov/pubmed/30887301
http://dx.doi.org/10.1007/s11605-019-04184-2
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author Buettner, Stefan
ten Cate, David W. G.
Bagante, Fabio
Alexandrescu, Sorin
Marques, Hugo P.
Lamelas, Jorge
Aldrighetti, Luca
Gamblin, T. Clark
Maithel, Shishir K.
Pulitano, Carlo
Margonis, Georgios Antonios
Weiss, Matthew
Bauer, Todd W.
Shen, Feng
Poultsides, George A.
Marsh, J. Wallis
IJzermans, Jan N. M.
Pawlik, Timothy M.
Koerkamp, Bas Groot
author_facet Buettner, Stefan
ten Cate, David W. G.
Bagante, Fabio
Alexandrescu, Sorin
Marques, Hugo P.
Lamelas, Jorge
Aldrighetti, Luca
Gamblin, T. Clark
Maithel, Shishir K.
Pulitano, Carlo
Margonis, Georgios Antonios
Weiss, Matthew
Bauer, Todd W.
Shen, Feng
Poultsides, George A.
Marsh, J. Wallis
IJzermans, Jan N. M.
Pawlik, Timothy M.
Koerkamp, Bas Groot
author_sort Buettner, Stefan
collection PubMed
description BACKGROUND: Multiple tumor foci of intrahepatic cholangiocarcinoma (ICC) are often considered a contra-indication for resection. We sought to define long-term outcomes after resection of ICC in patients with multiple foci. METHODS: Patients who underwent resection for ICC between 1990 and 2017 were identified from 12 major HPB centers. Outcomes of patients with solitary lesions, multiple lesions (ML), and oligometastases (OM) were compared. OM were defined as extrahepatic metastases spread to a single organ. RESULTS: One thousand thirteen patients underwent resection of ICC. On final pathology, 185 patients (18.4%) had ML and 27 (2.7%) had OM. Median survival of patients with a solitary tumor was 43.2 months, while the median survival of patients with 2 tumors was 21.2 months; the median survival of patients with 3 or more tumors was 15.3 months (p < 0.001). Five-year survival was 43.3%, 28.0%, and 8.6%, respectively. The median survival of patients without OM was 37.8 months versus 14.9 months among patients with OM (p < 0.001); estimated 5-year survival was 39.3% and 10.6%, respectively. In multivariable analysis, the presence of two lesions was not an independent poor prognostic factor for OS (HR 1.19; 95%CI 0.90–1.57; p = 0.229). However, the presence of three or more tumors was an independent poor prognostic factor for OS (HR 1.97; 95%CI 1.48–2.64; p < 0.001). CONCLUSION: Resection of multiple liver tumors for patients with ICC did not preclude 5-year survival: in particular, estimated 5-year OS for resection of two tumors was 28.0%. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s11605-019-04184-2) contains supplementary material, which is available to authorized users.
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spelling pubmed-68315342019-11-20 Survival after Resection of Multiple Tumor Foci of Intrahepatic Cholangiocarcinoma Buettner, Stefan ten Cate, David W. G. Bagante, Fabio Alexandrescu, Sorin Marques, Hugo P. Lamelas, Jorge Aldrighetti, Luca Gamblin, T. Clark Maithel, Shishir K. Pulitano, Carlo Margonis, Georgios Antonios Weiss, Matthew Bauer, Todd W. Shen, Feng Poultsides, George A. Marsh, J. Wallis IJzermans, Jan N. M. Pawlik, Timothy M. Koerkamp, Bas Groot J Gastrointest Surg Original Article BACKGROUND: Multiple tumor foci of intrahepatic cholangiocarcinoma (ICC) are often considered a contra-indication for resection. We sought to define long-term outcomes after resection of ICC in patients with multiple foci. METHODS: Patients who underwent resection for ICC between 1990 and 2017 were identified from 12 major HPB centers. Outcomes of patients with solitary lesions, multiple lesions (ML), and oligometastases (OM) were compared. OM were defined as extrahepatic metastases spread to a single organ. RESULTS: One thousand thirteen patients underwent resection of ICC. On final pathology, 185 patients (18.4%) had ML and 27 (2.7%) had OM. Median survival of patients with a solitary tumor was 43.2 months, while the median survival of patients with 2 tumors was 21.2 months; the median survival of patients with 3 or more tumors was 15.3 months (p < 0.001). Five-year survival was 43.3%, 28.0%, and 8.6%, respectively. The median survival of patients without OM was 37.8 months versus 14.9 months among patients with OM (p < 0.001); estimated 5-year survival was 39.3% and 10.6%, respectively. In multivariable analysis, the presence of two lesions was not an independent poor prognostic factor for OS (HR 1.19; 95%CI 0.90–1.57; p = 0.229). However, the presence of three or more tumors was an independent poor prognostic factor for OS (HR 1.97; 95%CI 1.48–2.64; p < 0.001). CONCLUSION: Resection of multiple liver tumors for patients with ICC did not preclude 5-year survival: in particular, estimated 5-year OS for resection of two tumors was 28.0%. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s11605-019-04184-2) contains supplementary material, which is available to authorized users. Springer US 2019-03-18 2019 /pmc/articles/PMC6831534/ /pubmed/30887301 http://dx.doi.org/10.1007/s11605-019-04184-2 Text en © The Author(s) 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Article
Buettner, Stefan
ten Cate, David W. G.
Bagante, Fabio
Alexandrescu, Sorin
Marques, Hugo P.
Lamelas, Jorge
Aldrighetti, Luca
Gamblin, T. Clark
Maithel, Shishir K.
Pulitano, Carlo
Margonis, Georgios Antonios
Weiss, Matthew
Bauer, Todd W.
Shen, Feng
Poultsides, George A.
Marsh, J. Wallis
IJzermans, Jan N. M.
Pawlik, Timothy M.
Koerkamp, Bas Groot
Survival after Resection of Multiple Tumor Foci of Intrahepatic Cholangiocarcinoma
title Survival after Resection of Multiple Tumor Foci of Intrahepatic Cholangiocarcinoma
title_full Survival after Resection of Multiple Tumor Foci of Intrahepatic Cholangiocarcinoma
title_fullStr Survival after Resection of Multiple Tumor Foci of Intrahepatic Cholangiocarcinoma
title_full_unstemmed Survival after Resection of Multiple Tumor Foci of Intrahepatic Cholangiocarcinoma
title_short Survival after Resection of Multiple Tumor Foci of Intrahepatic Cholangiocarcinoma
title_sort survival after resection of multiple tumor foci of intrahepatic cholangiocarcinoma
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6831534/
https://www.ncbi.nlm.nih.gov/pubmed/30887301
http://dx.doi.org/10.1007/s11605-019-04184-2
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