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Original Article |
1 Department of Medical and Surgical Sciences, Surgical Clinic, Brescia University, P.le Spedali Civili, 1, 25123 Brescia, Italy
2 Department of Radiology, Azienda Ospedaliera Spedali Civili di Brescia, Brescia, Italy
3 Department of Pathology, Brescia University, Brescia, Italy
Correspondence: Address correspondence and reprint requests to: Gian Luca Baiocchi, MD; E-mail: baioksurg{at}hotmail.com
Background: Intrahepatic cholangiocarcinoma (ICC) is an unusual tumour.
Methods: The clinicopathological data of 67 patients with ICC and combined hepatocellular–cholangiocarcinoma (HCC–ICC) are presented.
Results: HCV–HBV infection was present in 37.3% and chronic liver disease in 38.7% of cases, a rate higher than in the normal population; in these patients the cancer was small, often asymptomatic and of combined type. Liver resection was performed in 51 patients; at 1, 3 and 5 years, overall survival was 87.9%, 59.0%, and disease-free survival was 47.7% and 78.8%, 51.4%, and 46.7%, respectively. The better results were in the group of cirrhotic patients in whom ICC was diagnosed by a screening program for HCC (5-year survival 76.6%). Nodal metastasis showed negative prognostic value for both overall and disease-free survival; in N+ patients mean survival was 14.7 months after liver resection and lymph node dissection.
Conclusion: Viral infection and cirrhosis may be considered risk conditions for ICC and combined HCC–ICC; in resected patients survival was good. Nodal metastases must not be considered a contraindication for liver resection.
Key Words: HCC • Cholangiocarcinoma • Liver surgery • Hepatitis infection • Cirrhosis
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