Impact of preoperative prognostic factors on survival outcomes in intrahepatic cholangiocarcinoma:a retrospective cohort study
10.4174/astr.2025.108.6.345
- Author:
Hyun Jeong JEON
1
;
So Jeong YOON
;
Ho Chang CHAE
;
Hyeong Seok KIM
;
Sang Hyun SHIN
;
In Woong HAN
;
Jin Seok HEO
;
Hongbeom KIM
Author Information
1. Division of Hepatobiliary-Pancreatic Surgery, Department of Surgery, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, Korea
- Publication Type:ORIGINAL ARTICLE
- From:Annals of Surgical Treatment and Research
2025;108(6):345-351
- CountryRepublic of Korea
- Language:English
-
Abstract:
Purpose:This study assesses preoperative prognostic factors in intrahepatic cholangiocarcinoma (ICC) to improve risk assessment and inform clinical decisions, focusing on the role of lymph node dissection (LND).
Methods:We conducted a retrospective analysis of 234 patients who underwent surgery for ICC at a single institution between 2010 and 2019. Prognostic factors affecting overall survival (OS) were identified through univariate and multivariable logistic regression analyses. Patients were categorized into high-, intermediate-, and low-risk groups based on the number of adverse prognostic factors. Survival curves were compared between the groups that underwent LND and those that did not within each risk category.
Results:Of the 234 patients, 138 (59.0%) underwent LND, and 96 (41.0%) did not (non-LND). Significant prognostic factors included preoperative elevation of CEA (>5 ng/mL), CA 19-9 (>37 U/mL), tumor multiplicity, tumor size >5 cm, and extrahepatic invasion. These factors were associated with adverse OS (hazard ratio ranging from 1.69 to 2.54). High-risk patients had significantly lower median OS compared to intermediate and low-risk groups in both LND and non-LND cohorts, but no significant difference in median OS between LND and non-LND groups within each risk category was observed.
Conclusion:Preoperative prognostic factors such as CEA, CA 19-9, tumor size, and multiplicity are vital for assessing patient risk in ICC. These factors guide clinical decision-making and emphasize the need for targeted treatment strategies, including the consideration of LND, particularly in high-risk patients. The study underscores the importance of these prognostic indicators in enhancing treatment outcomes.
