Outcomes after resection of cholangiocellular carcinoma

Am J Surg. 2004 May;187(5):612-7. doi: 10.1016/j.amjsurg.2004.01.007.

Abstract

Background: Cholangiocellular carcinoma (CCC) is a rare primary liver malignancy that arises from intrahepatic bile duct canaliculi and presents as a liver mass. Our purpose is to report operative morbidity and mortality and to determine long-term survival after resection for CCC.

Methods: Retrospective review of 31 consecutive patients who underwent resection during a 20-year period.

Results: Thirty-day hospital mortality was 3%, and postoperative morbidity was 38%. Kaplan-Meier 5-year survival was 35%; mean survival was 37 months; absolute 5-year survival was 33%. Mean survival in stages I, II, IIIA, and IIIC were 57, 33, 26, and 14 months, respectively (P = 0.03 comparing I to >I). Recurrence occurred in 18 patients; 89% were in the liver. Carbohydrate antigen 19-9 >100 U/mL was found to be an indicator of poor prognosis (P = 0.009).

Conclusions: Resection for CCC can be performed with acceptable morbidity and mortality rates and results in good survival and cure. Hepatic recurrence is common. Carbohydrate antigen 19-9 may be useful in determining prognosis.

MeSH terms

  • Abdominal Pain / etiology
  • Adult
  • Aged
  • Aged, 80 and over
  • CA-19-9 Antigen / blood
  • Cholangiocarcinoma / blood
  • Cholangiocarcinoma / diagnosis
  • Cholangiocarcinoma / mortality*
  • Cholangiocarcinoma / surgery*
  • Female
  • Hepatectomy* / adverse effects
  • Hepatectomy* / methods
  • Hepatectomy* / mortality
  • Hospital Mortality
  • Humans
  • Liver Neoplasms / blood
  • Liver Neoplasms / diagnosis
  • Liver Neoplasms / mortality*
  • Liver Neoplasms / surgery*
  • Male
  • Middle Aged
  • Morbidity
  • Multivariate Analysis
  • Nausea / etiology
  • Neoplasm Recurrence, Local / epidemiology
  • Neoplasm Staging
  • Patient Selection
  • Predictive Value of Tests
  • Prognosis
  • Proportional Hazards Models
  • Retrospective Studies
  • Survival Analysis
  • Treatment Outcome

Substances

  • CA-19-9 Antigen