Conditional recurrence analysis of intrahepatic cholangiocarcinoma: Changes in recurrence rate and survival after recurrence resection by disease‐free interval

Author:

Maki Harufumi1,Kawaguchi Yoshikuni1ORCID,Nagata Rihito1,Mihara Yuichiro1,Ichida Akihiko1,Ishizawa Takeaki1ORCID,Akamatsu Nobuhisa1,Kaneko Junichi1,Arita Junichi1,Hasegawa Kiyoshi1

Affiliation:

1. Hepato‐Biliary‐Pancreatic Surgery Division, and Artificial Organ and Transplantation Division, Department of Surgery Graduate School of Medicine The University of Tokyo Tokyo Japan

Abstract

AbstractAimThe prognosis of patients with resected intrahepatic cholangiocarcinoma (ICC) is still unsatisfactory, with a high recurrence rate. We aimed to evaluate risks of recurrence changing over time and the survival benefit of resection for recurrent ICC.MethodsThis study included patients who underwent hepatectomy for ICC during 1995–2020. Risk factors for recurrence‐free survival (RFS) in patients undergoing initial resection and overall survival (OS) in patients who developed recurrence after initial resection were analyzed. Conditional cumulative incidence of recurrence was assessed.ResultsA total of 169 patients were included in the study and 114 patients (67.5%) developed recurrence. Cumulative analyses showed that the 5‐year recurrence rate was 69.3% at the time of initial resection but decreased to 24.8% in patients free from recurrence at 2 years after initial resection and 2.6% in patients free from recurrence at 4 years. Re‐resection was carried out in 26 (22.8%) of 114 patients who developed recurrence. Multivariable Cox proportional hazards model analysis indicated re‐resection (hazard ratio [HR] 0.19; 95% confidence interval [CI] 0.11–0.40, p < 0.001), microvascular invasion (MVI) (HR 2.39; 95% CI 1.05–5.40, p = 0.037), and disease‐free interval (months) (HR 0.97; 95% CI 0.95–1.00, p = 0.067) were significantly associated with longer OS after recurrence.ConclusionsAlthough the rate of recurrence remains high, conditional cumulative recurrence rate analysis showed that the rate of recurrence decreased by disease‐free interval. Resection of recurrent ICC was associated with improved OS, particularly among patients with longer disease‐free interval and absence of MVI after initial hepatectomy.

Publisher

Wiley

Subject

Infectious Diseases,Hepatology

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