Patients with recurrent intrahepatic cholangiocarcinoma (CCA) appear to benefit from tumor resection, according to a recently published study in Hepatology Research.

The incidence of CCA has significantly risen over the last decades, and the prognosis remains poor even for patients who undergo curative intent surgery, with a 5-year survival estimated at 30% and a recurrence rate between 50% and 70%.

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The prognosis of patients that experience recurrence after 2 years of disease-free survival (DFS) appears to be better than for those that experience recurrence in a shorter interval, the researchers noted. Furthermore, late and early recurrences could be associated with different risk factors, they added.

The concept of conditional recurrence-free survival (RFS) refers to the RFS probability after a given interval of disease-free survival. The authors hypothesize that it could be useful for selecting candidates for resection after recurrence.

The authors aimed to assess the utility of RFS as well as risk factors for RFS and overall survival (OS) using data from 169 patients, of which 144 experienced recurrence after curative intent surgery between 1995 and 2020.

The median follow-up of the included patients was of 5 years, during which 48% of patients died, and the median RFS was of 3 years. Multivariate Cox proportional hazard revealed that CA19-9, age, microvascular invasion (MVI), and lymph node metastasis were factors associated with an increased risk of recurrence.

Reresection was performed in 26 of the 114 patients who experienced recurrence. Results showed that patients that underwent surgery had a longer time to recurrence as well as lower CA19-9 levels and a higher proportion of solitary recurrence and intrahepatic recurrence than the patients that did not undergo surgery. The authors identified MVI and disease-free interval as factors associated with a longer OV after recurrence.

“Resection of recurrent ICC was associated with improved OS, particularly among patients with longer disease-free interval and absence of MVI after initial hepatectomy,” the authors concluded.


Maki H, Kawaguchi Y, Nagata R, et al. Conditional recurrence analysis of intrahepatic cholangiocarcinoma: changes in recurrence rate and survival after recurrence resection by disease‐free interval. Hepatol Res. Published online August 9, 2023. doi:10.1111/hepr.13951