Long-term survival was improved in patients with intrahepatic cholangiocarcinoma (CCA) who received anatomical resection (AR) compared to those receiving nonanatomical resection (NAR), according to a study published in the Journal of Oncology.

Using propensity score matching (PSM) analysis, patients receiving AR had improved overall survival (OS) and disease-free survival (DFS) than those who received NAR. After PSM, OS rates for patients who received AR were 70% at year 1, 46% at year 3, and 34% at year 5. Patients who received NAR had OS rates of 60% at year 1, 28% at year 3, and 16% at year 5 (P =.022).

The DFS rates for patients who received AR were 61% at year 1, 21% at year 3, and 10% at year 5, compared to 49% at year 1, 12% at year 3, and 4% at year 5 for the NAR group (P =.029).


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No difference was observed between the 2 groups in regard to the incidence of complications (P =.534), the types of complications (P =.882), or the Clavien-Dindo grade (P =.825). The patients who received AR did have a higher rate of intraoperative transfusion (13.13% vs 3.03%; P =.009) and longer hospital stays (10.77 vs 7.85; P =.008).

Recurrence rates were similar between the 2 groups during the follow-up period (84.85% vs 83.84%). Recurrence tended to be in distant segments for the AR group, while it tended to be less likely at the resection margin or adjacent segments compared to the NAR group. However, the difference was not significant. Notably, 1 patient who received NAR and 6 patients who received AR did not report disease recurrence during the follow-up period.

“In conclusion, AR improved the long-term survival of iCCA with comparable postoperative complications and similar recurrence patterns,” the authors said.

Using multivariate analysis, several risk factors for OS were identified, including NAR, a tumor size of more than 5 cm, multiple tumors, and poor differentiation. Risk factors for DFS also included NAR, tumor size of more than 5 cm, and poor differentiation.

There were 276 patients with iCCA initially included in the study, including 137 patients who received NAR and 139 who received AR. PSM reduced the number to 99 pairs. No significant difference was observed in baseline characteristics between the 2 groups after PSM.

Reference

Wang C, Ciren P, Danzeng A, et al. Anatomical resection improved the outcome of intrahepatic cholangiocarcinoma: a propensity score matching analysis of a retrospective cohort. J Oncol. Published online October 25, 2022. doi:10.1155/2022/4446243