Yoh T, et al. - Researchers here focused on the repeat surgery when analyzing the survival outcomes of recurrent intrahepatic cholangiocarcinoma (ICC). They observed that with an appropriate selection, repeat surgery for recurrent ICC could result in prolonged survival. Nodal status, number of tumors on the primary tumor, and time to recurrence could be considered as selection criteria regarding the feasibility.

Methods

• Researchers analyzed a total of 108 patients with recurrent ICC between 1993 and 2015.
• Repeat surgery was performed on 15 patients and 93 did not underwent the procedure.

Results

• Researchers identified 29 patients with intrahepatic recurrence; of these, 7 were amenable to the repeat surgery.
• Forty-four patients with extrahepatic recurrence were identified of whom 8 were amenable to the repeat surgery.
• They identified 35 patients with simultaneous or consequent intrahepatic recurrence and extrahepatic recurrence; these were not amenable to the repeat surgery.
• Repeat surgery was performed on patients who had a lower proportion of lymph node metastases (n = 0 [0%] vs. n = 47 [50.5%], p < 0.001), multiple tumors in the primary tumor (n = 1 [6.7%] vs n = 31 [33.3%], p = 0.037), or early recurrence (≤ 1 year; n = 4 [26.7%] vs n = 62 [66.7%], p = 0.003).
• In patients who underwent repeat surgery, survival after recurrence (SAR) was better than in those who did not (median SAR time: 91.6 vs. 10.4 months, and 3-year survival: 86.7 vs 8.7%, respectively, p < 0.001).