Risk Factors And Prognosis For Early Recurrence Of Intrahepatic Cholangiocarcinoma After Radical Resection

Background The risk factors for early tumor recurrence after radical resection of Intrahepatic cholangiocarcinoma(ICC)remains unclear.The purpose of our study was to analyze the risk factors for early tumor recurrence after ICC radical resection and to further determine the effect of early tumor recurrence on patient prognosis.Method In this study,107 patients who underwent radical ICC resection in the department of hepatobiliary surgery of fujian provincial hospital from June 2012 to March 2019 were collected as subjects to analyze the risk factors and prognosis of early tumor recurrence in ICC patients after radical resection.In this study,recurrence within 2 years after radical resection of ICC was defined as early tumor recurrence,and recurrence after 2 years was defined as late tumor recurrence.Result By the last follow-up date,a total of 55 patients had early postoperative tumor recurrence,8 patients had advanced postoperative tumor recurrence,and 44 patients had no postoperative tumor recurrence.Meanwhile,as of the last follow-up date,a total of 69 patients(64.5%)died and 38 patients(35.5%)survived.In this study,the selection of the age,gender,BMI,prothrombin time,albumin,total bilirubin,alanine aminotransferase,glutamyl transpeptidase,alpha-fetal protein,carcinoembryonic antigen,carbohydrate antigen 19-9,liver cirrhosis,tumour size,tumor number,resection procedure,lymph node metastasis,microvascular invasion,perineural invasion,bile duct resection and reconstruction,intraoperative blood transfusion,tumor differentiation,TNM stage and the postoperative complications as clinical pathological features,research the ICC risk factors for early recurrence after radical resection of tumor and prognosis.Survival analysis showed that the prognosis of patients with early tumor recurrence after surgery was worse than that of patients without tumor recurrence(median survival was 17 months and 36 months,respectively;1,3,5-year cumulative survival rates were 61.0%,20.4%,8.2% and90.9%,53.8% and 31.9%,respectively;P < 0.0001).At the same time,the prognosis of patients with early recurrence was also worse than those with late recurrence(median survival was 17 months and 30 months,respectively;1,3,5-year cumulative survival rates were 61.0%,20.4%,8.2% and 87.5%,37.5% and 25.0%,respectively;p= 0.037 < 0.05).Multivariate Cox regression analysis showed that the elevated serum CA19-9 level(HR,2.014;95%CI,1.080-3.754;p=0.028 <0.05),multiple tumors(HR,2.176;95%CI,1.134-4.178;p=0.019<0.05),lymph node metastasis(HR,1.953;95%CI,1.081-3.531;p=0.027<0.05)was an independent risk factor for early tumor recurrence after radical ICC resection.The prognosis of patients with early tumor recurrence after ICC radical resection who received curative treatment was better than that of patients who received palliative treatment(median survival was 35 months and 20 months,respectively.1,2 and 3-year cumulative survival rates were 80.0%,57.5%,43.8% and 66.7%,29.2%,0,respectively;p=0.019< 0.05).At the same time,the prognosis of patients with early recurrence receiving curative treatment was similar to that of patients without recurrence(median survival was 35 months and 36 months,respectively;1,3,5-year cumulative survival rates were 80.0%,43.8%,17.5% and 90.9%,53.8%,31.9%,respectively;p=0.429 > 0.05).Conclusion The results showed that several aggressive tumor characteristics(high serum CA19-9 levels,multiple tumors,and lymph node metastasis)were significantly associated with an increased risk of early tumor recurrence after radical ICC resection,The prognosis of patients with early tumor recurrence after surgery was worse than those with late tumor recurrence or without tumor recurrence,The patients with early recurrence of tumor after surgery can get a good prognosis after receiving curative treatment.Therefore,it is strongly recommended that patients with high risk factors for early tumor recurrence should be followed up closely to achieve "early detection and early treatment",Striving to detect tumor recurrence at an early stage and receive curative treatment after recurrence to improve the prognosis.