Aggressive Surgical Treatment for Intrahepatic Cholangiocarcinoma and Prognostic factors.
- Author:
Hong Jin KIM
1
;
Sung Su YUN
;
Juong Uuk KO
;
Joon Hyuk CHOI
;
Jay Chun CHANG
;
Koing Bo KWUN
Author Information
1. Department of Surgery, College of Medicine, Yeungnam University,Taegu,Korea.
- Publication Type:Original Article
- Keywords:
Cholangiocarcinoma;
Hepatectomy;
p53;
Ki-67
- MeSH:
Antibodies, Monoclonal;
Biomarkers;
Cell Differentiation;
Cholangiocarcinoma*;
Fibrinogen;
Hepatectomy;
Humans;
Laparotomy;
Liver;
Lymph Node Excision;
Lymph Nodes;
Mastectomy, Segmental;
Prognosis;
Survival Rate;
Biomarkers, Tumor
- From:Korean Journal of Hepato-Biliary-Pancreatic Surgery
1999;3(1):27-36
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: To review the cases of surgically-treated intrahepatic cholangiocarcinoma, and to evaluate the clinical and pathologic features of intrahepatic cholangiocarcinoma that may affect longterm survival among Korean patients. MATERIALS AND METHODS: From 1990 to 1997, 28 patients with intrahepatic cholangiocarcinoma underwent laparotomy. Among them, resection was performed in 25 patients and wedge resection in only 3 patients. The liver resections included: 5 right lobectomies, 1 right trisegmentectomy, 7 left lobectomies, 3 extended left lobectomies, 2 hepatopancreatoduodenectomies and 7 segmentectomies. Curative resection was performed on 15 patients. The histological sections of all resected specimens were immunohistochemically stained with p53 and Ki-67 monoclonal antibodies to assess biological behavior of the tumor cells. The cumulative survival rate and clinicopathological factors, including biological markers (p53, Ki-67), that may influence prognosis were analyzed stastistically. RESULTS: The patients undergoing curative resection survived significantly longer than the patients undergoing noncurative resection. The median survival time for patients with curative resection was 24 months (mean, 34+/-8 months) with 1-, 2-, and 3-year survival rates of 66.6%, 44.4%, and 35.6%, respectively. The median survival time for patients with noncurative resection was 3 months (mean, 8+/-3 months) with 1- and 2-year survival rates of 26.7% and 13.4%, respectively. Univariate analysis showed that positive regional lymph node significantly correlated with poor prognosis (p=0.004); and that curative resection significantly correlated with better prognosis (p=0.001). Age, sex, tumor size, the degree of cell differentiation, gross type of tumor, and p53 and Ki-67 labeling index had no significant correlation with prognosis. CONCLUSION: Our results support the idea that an aggressive liver resection along with regional lymph node dissection is recommended for long-term survival. The validity of the molecular biologic tumor markers (p53, Ki -67) as a prognostic factor is not yet clearly defined.
