The EASL guidelines for intrahepatic cholangiocarcinoma (ICC) discouraged resection for ICC patients with lymph node metastasis (LNM), intrahepatic metastasis (IM), or vascular invasion (VI). The clinical impact of hepatectomy in ICC patients with IM, periductal infiltration (MF+PI), LNM, and VI remains unclear.
Patients ICC who underwent hepatectomy for MF dominant ICC and unresected patients due to IM, LNM, or locally advanced tumors (unresectable group) were enrolled. The clinical impact of CA19-9 and hepatectomy were evaluated in ICC. The best CA19-9 cut-off value for ICC was examined based on the overall survival (OS). The surgical outcomes of patients who underwent hepatectomy for ICC with LNM, IM, VI, or PI were investigated, and survival of those patients was compared with that of patients with unresectable ICC based on their prognostic factors.
A total of 73 resected patients and 20 unresectable patients were enrolled. The optimal CA19-9 cut-off value (based on the greatest difference in overall survival [OS]), was 300 U/mL. The OS at CA19-9
Even if ICC patients develop IM, PI, LNM, or VI, or require major vascular resection, hepatectomy can be considered for selected patients with CA19-9
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All authors have declared no conflicts of interest.