SURGICAL-TREATMENT OF 32 PATIENTS WITH PERIPHERAL INTRAHEPATIC CHOLANGIOCARCINOMA

Background Peripheral intrahepatic cholangiocarcinoma (PIC) is an intr ahepatic primary liver neoplasm which is clinicopathologically distinc t from hepatocellular carcinoma and major duct cholangiocarcinoma. The clinical outcome after resection of these rare tumours is not well do cumented. Methods Review of the hepatic database and tumour registry a t Memorial Sloan-Kettering Cancer Center identified 32 cases of PIC re sected for cure over a 23-year period. Intrahepatic cholangiocarcinoma s with major bile duct involvement were excluded from this analysis. D emographics, pathological features, biochemical markers, operative res ults and survival were analysed. Results The majority of patients pres ented with abdominal pain (n = 19). Only two patients had pathological evidence of hepatic cirrhosis. Serum marker levels included alpha-fet oprotein (AFP; median 3.7 (range 0-225) ng/ml) and carcinoembryonic an tigen (CEA; median 1.6 (range 0-30) ng/ml). Type of hepatic resection included: wedge (n = 2), lobectomy (n = 14) and extended lobectomy (n = 16). There was one postoperative death. Median follow-up time was 27 months. Median survival was 59 months with an actuarial 5-year surviv al of 42 per cent. Vascular invasion and intrahepatic satellite lesion s were predictors of worse survival (P < 0.05). Conclusion PIC is a ra re hepatic primary tumour, which usually presents in non-cirrhotic liv ers with a normal serum AFP and CEA level. In selected patients, compl ete surgical resection can be performed safely and is associated with long-term survival.