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Is There an Optimal Extent of Liver Resection in Patients with Intrahepatic Cholangiocarcinoma?
( Masakazu Yamamoto ),( Shun-ichi Ariizumi ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1
Aim: No evidence of anatomical hepatectomy or extended hepatectomy for patients with intrahepatic cholangiocarcinoma (ICC) shows good surgical outcomes. We compared the surgical outcomes of ICC with those of hepatocellular carcinoma (HCC). Methods: From 1990 to 2014, 1784 patients with HCC and 118 patients with mass-forming type ICC underwent hepatectomy at Tokyo Women’s Medical University. 60 ICC and 1350 HCC patients were selected according to the criterion of a single nodular type tumor less than 5 cm in diameter. Surgical procedures, recurrent sites, recurrence-free survival (RFS) and overall survival (OS) were compared between HCC and ICC patients. Results: With regard to the background, the ratio of males and the rate of liver cirrhosis were significantly higher in HCC patients. With regard to the tumor and surgical factors, the tumor size was smaller, and the rates of vascular invasion, lymph node metastasis and major hepatectomy were significantly lower in HCC patients. RFS and OS were 35%, 32% and 59%, 69% in ICC and HCC, respectively. There were no significant differences in RFS and OS between ICC and HCC. However, the early recurrence rate and the rate of distant metastasis were higher in ICC patients. Conclusion: The optimal extent of liver resection could not be found in our data. To improve the long-term survival, we need effective systemic adjuvant therapy after hepatectomy for ICC.