Influencing factors for the prognosis of patients with early-stage intrahepatic cholangiocarcinoma after radical resection

Objective To investigate the influencing factors for the prognosis of patients with early-stage intrahepatic cholangiocarcinoma ( ICC) after surgical treatment. Methods A total of 155 patients with early-stage ICC who underwent radical resection in The Third Affiliated Hospital of Second Military Medical University from January 2013 to December 2014 were enrolled in this study. Clinicopathological features and 1-, 2-, and 3-year overall survival rates and disease-free survival rates after surgery were analyzed. The Cox forward stepwise regression was used for the univariate and multivariate analyses of the influencing factors for the prognosis of early-stage ICC. Results Most patients with early-stage ICC were middle-aged men, with an average tumor diameter of 5. 8 ± 2. 5 cm. Most patients had normal liver function, but there were varying degrees of increase in carbohydrate antigen 19-9 ( CA19-9) level. Postoperative pathological examination revealed highly or moderately differentiated adenocarcinoma in most patients. The 1-, 2-, and 3-year overall survival rates after surgery were 76. 1%, 43. 9%, and 34. 1%, respectively, and the 1-, 2-, and 3-year disease-free survival rates were 50. 3%, 25. 0%, and 18. 1%, respectively. The Cox multivariate analysis showed that high CA19-9 level before surgery ( hazard ratio [HR]=1. 705, 95% confidence interval [CI]: 1. 096-2. 652, P = 0. 018) , liver cirrhosis ( HR = 2. 399, 95% CI: 1. 108-5. 196, P = 0. 026) , satellite nodules ( HR = 1. 918, 95% CI: 1. 124-3. 272, P = 0. 017) , and degree of tumor cell differentiation ( HR = 5. 568, 95% CI:2. 591-11. 965, P < 0. 0001) were independent risk factors for overall survival of patients early-stage ICC. Liver cirrhosis ( HR = 2. 142, 95% CI: 1. 054-4. 353, P = 0. 035) , satellite nodules ( HR = 2. 045, 95% CI: 1. 250-3. 343, P = 0. 004) , and degree of tumor cell differentiation ( HR = 2. 748, 95% CI: 1. 340-5. 638, P = 0. 006) were independent risk factors for disease-free survival of patients early-stage ICC. Conclusion Radical resection is the preferred treatment for patients with early-stage ICC. Preoperative CA19-9 ≥200 U/ml, liver cirrhosis, satellite nodules, and degree of tumor cell differentiation are independent risk factors for the prognosis of early-stage ICC.