Clinical Characteristics And Prognostic Factors Of The Hepatolithiasis Assosiated With Intrahepatic Cholangiocarcinoma

ObjectiveTo investigate the clinical characteristics and prognostic factors ofhepatolithiasis associated with intrahepatic cholangiocarcinoma.MethodsThe clinical data of the hospitalized patients who were diagnosed withhepatolithiasis associated with intrahepatic cholangiocarcinoma in the FirstAffiliated Hospital of Chongqing Medical University, from2006to2013,was retrospectively analyzed and statistical analysis was performed usingSPSS16.0. Overall survival of all patients was asessed using theKaplan-Meier method. Possible prognostic factors such as age, course ofhepatolithiasis, serum CA19-9levles and surgical methods were tested bylog-rank test, to build Cox proportional hazards regression model.Results39cases associated with intrahepatic cholangiocarcinoma in586patients who were treated with hepatolithiasis, accounted for6.7%. Themain clinical manifestations were recurrent fever, abdominal pain, jaundice and hepatic percussion pain. Duration of the hepatolithiasis was1to42years, mean16.7years. Laboratory tests showed serum CA19-9waspositive. Imaging studies showed the bile duct wall, parts of thehepatolithiasis, was thickening or occupying lesions. The tumor occurred inthe left lateral lobe of the liver accounted for61.5%, the posterior rightlobe28.2%. Radical surgery survived for16to49months, with an averagesurvival period of29.4months, however, palliative surgery survived for3to14months, with an average survival period of10.8months. The patient’sdeath was largely due to tumor recurrence and metastasis. The shortestsurvival time in patients was two months after surgery, mainly forlaparotomy with biopsy alone. In39cases of hepatolithiasis associated withintrahepatic cholangiocarcinoma, older than60years old accounted for69.2%, course of hepatolithiasis more than10years accounted for76.9%.Remarkable difference was found in serum CA19-9levles and surgerymethods by Cox proportional hazards regression model (P <0.05).Conclusions1. Greater chance of hepatolithiasis associated with intrahepaticcholangiocarcinoma were found in patients more than60years of age or(and) course of hepatolithiasis more than10years.2. The patients who were diagnosed with hepatolithiasis associatedwith intrahepatic cholangiocarcinoma had long course of disease, recurrentfever, abdominal pain, jaundice and hepatic percussion pain. Serum CA19-9was positive. Imaging studies showed the bile duct wall, parts ofthe hepatolithiasis, was thickening or occupying lesions. The tumoroccurred mainly in the left lateral lobe and the posterior right lobe of theliver.3. Serum CA19-9levels and surgical methods were the most importantprognostic factors.