Outcomes of intrahepatic cholangiocarcinoma with portal vein tumor thrombus following hepatic resection

J Gastroenterol Hepatol. 2016 Jul;31(7):1330-5. doi: 10.1111/jgh.13309.

Abstract

Background and aim: Portal vein tumor thrombus (PVTT) is not commonly used in the treatment of intrahepatic cholangiocarcinoma (ICC), and its impact on the prognosis of ICC is unclear. We aimed to assess the outcomes of ICC with or without PVTT after hepatic resection.

Methods: From January 2000 to December 2005, the data from all consecutive patients with ICC who underwent hepatic resection at our hospital were retrospectively analyzed. According to the Cheng's PVTT Classification (types I-IV), we compared the survival outcomes of ICC patients (with or without PVTT) and prognosis of patients with ICC with different types of PVTT.

Results: Three hundred and three patients with ICC were enrolled in this study (59 with PVTT). The incidence of PVTT was 19.4% (59/303). The median survival times were 12.68 and 28.91 months for ICC patients with and without PVTT, respectively (P < 0.001). The multivariate analysis demonstrated that PVTT (hazard ratio [HR] 1.783; confidence interval 95% [1.279; 2.487]) was an independent risk factor for overall survival. Patients with type I PVTT exhibited significantly better survival than those with types II and III PVTT.

Conclusion: The ICC patients with PVTT exhibit a poorer prognosis compared with ICC patients without PVTT after hepatic resection.

Keywords: DFS; ICC; OS; PVTT.

MeSH terms

  • Bile Duct Neoplasms / mortality
  • Bile Duct Neoplasms / surgery*
  • Cholangiocarcinoma / mortality
  • Cholangiocarcinoma / surgery*
  • Cohort Studies
  • Female
  • Hepatectomy*
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Portal Vein*
  • Postoperative Complications*
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Survival Rate
  • Treatment Outcome
  • Venous Thrombosis* / classification