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Conference Proceeding

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Background: Intrahepatic cholangiocarcinoma (iCCA) is the second most common primary liver cancer with increasing rates of incidence and mortality. Surgical resection with negative margins and regional lymphadenectomy is the mainstay of the treatment for patients with resectable-iCCA. Because of its rarity and low resectability rate of iCCA, prognostic markers and outcomes of patients who undergo liver resection are not well defined. We aimed to evaluate the characteristics of patients undergoing liver resection for iCCA at our institution over ten years. Methods: All patients with iCCA who had liver resection between 3/2013-3/2023 at our institution were included in the study. An institutional review board approval was obtained by our institution. Patients who had neoadjuvant therapy prior to resection and patients with a history of malignancy were excluded. Demographic, clinical, radiological, and histological data were collected. Continuous variables are reported as median (interquartile range, IQR), and categorical variables by counts and percentages. Results: A total of 68 patients (36 female, 32 male) were included in the final analysis. The median age at resection was 66 years (57.2-74). Liver cirrhosis was present on histology in four patients (5.8%), of which three had non-alcoholic steatohepatitis, and one had primary sclerosing cholangitis. Of all patients, 52.9% had hypertension, 22% had diabetes mellitus, 8.8% had inflammatory bowel disease, 25% had clinically significant alcohol use history, and 47% had former or current tobacco use for more than 5 pack-years. The median preoperative BMI was 27.84 kg/m2 (25-32). Pre-operative values of albumin, total bilirubin, AST, ALT, ALP, CA19-9, CEA, and AFP are shown in table 1. The median tumor size was 4.2 cm (3.1-5.9), and 16.1% of the patients had satellite lesions. 36.7% of the patients had lymph node invasion, 30.8% had perineural invasion, and 16.1% had vascular invasion on liver histology. Positive surgical margins were present in 19.1% of patients. Progression of disease or recurrence was seen in 58.8% of patients in a median of 1.1 years (0.7-1.7), and 25% of the patients died during follow-up. Duration from liver resection to last follow-up or death was 1.5 years (0.8-2.9). Conclusion: Our results show that iCCA has a high risk of progression/ recurrence despite curative resection. Predictive markers of recurrence and survival in patients vary in the literature and remain to be validated.





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American Association for the Study of Liver Diseases AASLD, The Liver Meeting, November 10-14, 2023, Boston, MA