Clinical Report: Long-term Outcomes Following Surgical Resection of Intrahepatic Cholangiocarcinoma

Overview

This study evaluates the long-term outcomes of surgical resection for intrahepatic cholangiocarcinoma (ICC) in relation to adjuvant capecitabine therapy. While median overall survival did not show significant improvement, time to recurrence and recurrence-free survival were significantly better in the post-BILCAP cohort.

Background

Intrahepatic cholangiocarcinoma (ICC) is a rare and aggressive malignancy with poor long-term survival rates. Surgical resection remains the only curative option, but tumor recurrence is common. The introduction of adjuvant capecitabine therapy has raised questions regarding its impact on survival outcomes, necessitating further investigation.

Data Highlights

Key Findings

• 334 patients were included in the study, with 254 undergoing surgical resection.
• After propensity score matching, two groups of 75 patients were compared.
• Median overall survival was 20.5 months for the pre-BILCAP group and 29.1 months for the post-BILCAP group (p = 0.351).
• Time to recurrence was significantly longer in the post-BILCAP group (21.3 months vs. 10.8 months, p = 0.019).
• Recurrence-free survival was also significantly better in the post-BILCAP group (10.7 months vs. 8.6 months, p = 0.029).
• No significant overall survival benefit was demonstrated with adjuvant capecitabine on an intention to treat basis.

Clinical Implications

The findings suggest that while adjuvant capecitabine may not significantly improve overall survival in ICC patients post-resection, it does appear to enhance time to recurrence and recurrence-free survival. Clinicians should consider these factors when discussing treatment options with patients.

Conclusion

The study highlights the need for ongoing evaluation of adjuvant therapies in ICC, particularly regarding their impact on recurrence rates. Further research is warranted to clarify the long-term benefits of capecitabine in this patient population.

Related Resources & Content

1. A Novel Surgical Approach for Intrahepatic Cholangiocarcinoma: The Hilar-First Strategy, Journal of Gastrointestinal Surgery, 2023 -- https://link.springer.com/article/10.1007/s00423-023-03023-y
2. Customized Strategies for Managing Lymph Node-Positive Perihilar Cholangiocarcinoma, Journal of Gastrointestinal Surgery, 2021 -- https://link.springer.com/article/10.1007/s00423-021-02154-4
3. Outcomes Following Surgical Resection of Multiple Tumor Sites in Intrahepatic Cholangiocarcinoma, Journal of Gastrointestinal Surgery, 2019 -- https://link.springer.com/article/10.1007/s11605-019-04184-2
4. Biliary Tract Cancers, Version 2.2025, NCCN Clinical Practice Guidelines In Oncology, PubMed -- https://pubmed.ncbi.nlm.nih.gov/40930144/?utm_source=openai
5. A Novel Surgical Approach for Intrahepatic Cholangiocarcinoma: The Hilar-First Strategy
6. Customized Strategies for Managing Lymph Node-Positive Perihilar Cholangiocarcinoma
7. Journal of Gastrointestinal Surgery — Outcomes Following Surgical Resection of Multiple Tumor Sites in Intrahepatic Cholangiocarcinoma
8. R0 Two-Stage Hepatectomy with Portal Vein Ligation: Advancing Treatment for Patients with Extensive Bilobular Colorectal Liver Metastases
9. Biliary Tract Cancers, Version 2.2025, NCCN Clinical Practice Guidelines In Oncology - PubMed
10. Frontiers | Impact of lymph node dissection on the prognosis of intrahepatic cholangiocarcinoma: a systematic review and meta-analysis