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Surgical Resection for Recurrent Intrahepatic Cholangiocarcinoma

  • Fabian Bartsch
  • Markus Paschold
  • Janine Baumgart
  • Maria Hoppe-Lotichius
  • Stefan Heinrich
  • Hauke Lang
Original Scientific Report

Abstract

Background

Although after R0 resection of intrahepatic cholangiocarcinoma (ICC) recurrence is frequent, most guidelines do not address strategies for this. The aim of this study was to analyze the outcome of repeated resection and to determine criteria when repeated resection is reasonable.

Methods

Between 2008 and 2016, we consecutively collected all cases of ICC (n = 176) in a prospective database and further analyzed them with a focus on tumor recurrence, its surgical treatment, overall survival and recurrence-free survival.

Results

Overall, a total of 22 explorations were performed for recurrent ICC in 17 patients. Resection rate was 18 repeated resections in 13 patients. Three patients underwent repeated resection twice and one patient three times. Recurrence was solitary in 7 patients and multifocal in 11 re-resected cases. Median overall survival (OS) of patients who underwent repeated resection was 65.2 months (interquartile range 37–126.5) with a 5-year OS rate of 62%, calculated from primary resection. Patients who underwent repeated resections had a significant better OS compared to those receiving chemotherapy, transarterial chemoembolization, selective internal radiotherapy, radiofrequency ablation or best supportive care (p < 0.001).

Conclusion

Repeated resection of recurrent ICC is reasonable and associated with an improved survival. Re-exploration should be considered as long as resection is technically possible.

Notes

Compliance with ethical standards

Conflict of interest

There are no conflicts to declare or financial relationships to disclose.

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Copyright information

© Société Internationale de Chirurgie 2018

Authors and Affiliations

  • Fabian Bartsch
    • 1
  • Markus Paschold
    • 1
  • Janine Baumgart
    • 1
  • Maria Hoppe-Lotichius
    • 1
  • Stefan Heinrich
    • 1
  • Hauke Lang
    • 1
  1. 1.Department of General, Visceral and Transplant SurgeryUniversity Medical Center of the Johannes Gutenberg-University MainzMainzGermany

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