Background: This study sought to determine clinical and molecular factors related to recurrence and survival in patients with ICC following hepatectomy.
Methods: Database review identified 34 patients. Molecular markers (Ki67, p53, beta-catenin) and standard pathological evaluations were performed.
Results: The most common resections were right (n = 11), extended right (n = 8), and left hepatectomy (n = 7). The 30- and 90 -day mortality rates were 5.9% and 11.8%. The median tumor size was 7.8 cm. Nine patients (26.5%) had positive lymph nodes and ten patients (29.4%) received adjuvant therapy. Median follow up was 33.5 months. The median disease-free interval was 6 months. The median overall survival was 37.9 months. Univariate predictors of recurrence were tumor size (P = 0.02) and differentiation (P = 0.05). On multivariate analysis, differentiation (P = 0.03; OR = 0.38; 95% CI: 0.17-0.89) remained significant. Univariate predictors of survival were tumor size (P = 0.02), lymphovascular invasion (P = 0.02), satellite nodules (P = 0.006), beta-catenin expression (P = 0.008), and recurrence (P = 0.026). On multivariate analyses, satellite lesions (P = 0.05, OR = 3.15, 95% CI: 0.96-10.4) and beta-catenin (P = 0.04, OR = 3.23; 95% CI: 1.1-9.7) remained significant and differentiation (P = 0.045; OR = 0.42; 95% CI: 0.18-0.98) was an additional predictor.
Conclusion: Future clinical trials could include certain molecular and pathologic factors to assist in determining the necessity and type of adjuvant therapy.
Keywords: Cholangiocarcinoma; beta-catenin; bile duct cancer.
© 2013 Wiley Periodicals, Inc.