Background

We investigated the vascularity of intrahepatic cholangiocarcinoma (ICC) on computed tomography (CT) images and its association with ICC recurrence after surgery and prognosis after recurrence.

Methods

In this retrospective study, the data of patients who underwent resection with curative intent for ICC between March 2001 and July 2017 were reviewed. Clinicopathologic factors including tumor vascularity (hypovascular, rim-enhancement, and hypervascular) on CT that could affect recurrence-free survival (RFS) were assessed. The association between the vascularity of recurrent ICC and survival after recurrence was also analyzed.

Results

Overall, 147 patients were enrolled and followed up for a median of 36.1 months of which, 101 (68.7%) experienced ICC recurrence. Hypervascularity of ICC showed better RFS than other vascularities [rim-enhanced image hazard ratio (HR), 3.893; 95% confidence interval (CI), 1.700–8.915, p = 0.001; hypovascular image HR, 6.241; 95% CI, 2.670–14.586, p < 0.001]. The hypervascular recurrent ICC was also significantly associated with better survival after recurrence (log-rank test, p < 0.001).

Conclusion

Hypervascular ICC was associated with a longer RFS and better prognosis after recurrence. The vascularity of ICC on CT may be a noninvasive, accessible, and useful prognostic index, and should be considered while planning treatment.

中文翻译：

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肿瘤血管分布对可切除肝内胆管癌 CT 预后的影响

背景

我们在计算机断层扫描 (CT) 图像上研究了肝内胆管癌 (ICC) 的血管分布及其与术后 ICC 复发和复发后预后的关系。

方法

在这项回顾性研究中，回顾了 2001 年 3 月至 2017 年 7 月期间接受根治性切除 ICC 的患者的数据。评估了可能影响无复发生存期 (RFS) 的临床病理因素，包括 CT 上的肿瘤血管分布（血管不足、边缘增强和血管过多）。还分析了复发性ICC的血管分布与复发后生存率之间的关系。

结果

总体而言，147 名患者入组并随访中位时间为 36.1 个月，其中 101 名（68.7%）出现 ICC 复发。ICC 的血管过多显示出比其他血管更好的 RFS [边缘增强图像风险比 (HR)，3.893；95% 置信区间 (CI)，1.700–8.915，p = 0.001；低血管图像 HR，6.241；95% CI，2.670–14.586，p < 0.001]。多血管复发性 ICC 也与复发后更好的生存率显着相关（对数秩检验，p < 0.001）。

结论

富血管 ICC 与更长的 RFS 和复发后更好的预后相关。CT 上 ICC 的血管分布可能是一种无创、可及且有用的预后指标，在计划治疗时应予以考虑。