Clinicopathological and prognostic analysis of 429 patients with intrahepatic cholangiocarcinoma

Table 1 Clinicopathological characteristics of 429 ICC patients

	No. of cases	Total No. of cases	Percentage (%)
Gender		429
Male	301		70.2
Female	128		29.8
Age (yr)		429
< 53	220		51.3
≥ 53	209		48.7
Choledocholithiasis		429
No	383		89.3
Yes	46		10.7
Pathology T		429
T1	11		2.5
T2	159		37.1
T3	112		26.1
T4	147		34.3
Pathology N		429
N0	341		79.5
N1	88		20.5
Pathology M		429
M0	408		95.1
M1	21		4.9
Pathology stage		429
I	11		2.5
II	126		29.4
III	133		31.0
IV	159		37.1
Maximum tumor diameter (cm)		429
≤ 5	145		33.8
> 5, ≤ 10	186		43.4
> 10	76		17.7
Diffuse type	22		5.1
Macroscopic satellite lesions		429
No	330		76.9
≤ 3	40		9.3
> 3	59		13.8
Macroscopic tumor thrombi		429
No	382		89.0
In blood vessel	32		7.5
In bile duct	10		2.3
In both	5		1.2
Serum HBsAg and HBcAb		427
HBsAg (+)	198		46.4
HBsAg (-) and HBcAb (+)	60		14.0
HBsAg (-) and HBcAb (-)	169		39.6
Serum AFP ( μg/L)		422
No	332		78.7
> 20, ≤ 1000	70		16.6
> 1000	20		4.7
Serum CEA ( μg/L)		420
No	370		88.1
> 10, ≤ 100	36		8.6
> 100	14		3.3
Serum CA19-9 (U/mL)		421
No	179		42.5
> 37, ≤ 507	143		34.0
> 507	99		23.5

ICC: Intrahepatic cholangiocarcinoma; AFP: α-fetoprotein; CEA: Carcinoembryonic antigen; CA19-9: Carbohydrate antigen 19-9.

Table 2 Surgery selection and prognosis

Surgical procedures	n	Ratio (%)	Median survival time (mo)	Survival rate (%)			P value
				1-yr	3-yr	5-yr
R0a	319	74.3	18.3	62.5	30.2	23.6	0.000
R1b	76	17.7	6.6	25.4	0	0
Exploratory laparotomy	34	7.9	5.6	3.6	0	0
Total	429	100	12.4	50.9	22.2	17.4

^aR0 vs R1 or exploratory laparotomy, P = 0.000;

^bR1 vs exploratory laparotomy, P = 0.360.

Table 3 Multivariate analysis of patient survival

	Regression coefficient	Standard error	P value	Relative risk	95% CI
Curative resection	0.658	0.173	0.000	1.931	1.375-2.713
Lymph node metastases	0.432	0.218	0.048	1.540	1.004-2.361
Macroscopic tumor thrombi	0.455	0.206	0.027	1.576	1.053-2.360
Tumor size	0.159	0.080	0.046	1.173	1.003-1.372
CA19-9	0.191	0.085	0.024	1.210	1.025-1.428

Table 4 Association of CA19-9 with clinicopathological parameters of the patients

	CA19-9 expression
	> 37 U/mL	≤37 U/mL	P value
Gender			0.032
Male	159	135
Female	83	44
Age (yr)			0.040
< 53	112	101
≥ 53	130	78
Surgical procedures			0.106
R0	174	139
R1	44	32
Exploratory laparotomy	24	8
Lymph node metastasis			0.082
Yes	182	148
No	57	30
Macroscopic satellite lesions			0.229
No	184	140
≤ 3	20	20
> 3	38	19
Extrahepatic metastases			0.185
Yes	227	179
No	15	6
Macroscopic tumor thrombi			0.440
Yes	218	157
No	24	22
Microscopic tumor thrombi			0.192
Yes	142	120
No	83	53
Tumor differentiation			0.221
Well	4	1
Moderate	85	52
Poorly	126	105
Number of lesions			0.843
Single	160	120
Multiple	82	59
Tumor size (cm)			0.002
≤ 5	69	72
> 5, ≤ 10	120	64
> 10	37	39
Diffuse type	16	4
HBsAg			0.049
Yes	101	92
No	141	87
Cirrhosis			0.000
Yes	68	80
No	174	99

Table 5 Logistic regression analysis in relationship between CA19-9 expression, lymph node metastases, and liver cirrhosis

	Regression coefficient	Standard error	P value	Relative risk	95% CI
Lymph node metastases	0.637	0.295	0.031	1.891	1.060-3.374
Cirrhosis	-0.539	0.230	0.019	0.584	0.372-0.915
Constant	0.336	0.146	0.021	1.340

Table 6 Comparison of post-operative survival after R0 resection

Author	No. of total	No. of R0	Ratio (%)	Survival (%)
				1-yr	3-yr	5-yr
Ohtsuka et al[22], 2003	50	34	68	61.6	37.6	22.5
Morimoto et al[23], 20031	51	35	68.6	68.2	44.1	32.4
Nakagawa et al[24], 2005	53	44	83.0	66.2	38.3	26.3
Lang et al[25], 2006	54	30	55.5	83	58	48
DeOliveira et al[26], 2007	44	34	77.3	NR	NR	63
Konstadoulakis et al[27], 2008	72	54	75	80	49	25
Our current study	429	319	74.3	62.5	30.2	23.6

¹Two cases of death were excluded. NR: Not reported.