Oncological relevance of major hepatectomy with inferior vena cava resection for intrahepatic cholangiocarcinoma

Background: This study aimed to investigate the short-and long-terms outcomes of patients undergoing major hepatectomy (MH) with inferior vena cava (IVC) resection for intrahepatic cholangiocarcinoma (ICC). Methods: Data from all patients who underwent MH for ICC with or without IVC resection between 2010 and 2018 were analysed retrospectively. Postoperative outcomes, overall survival (OS), and recurrence free survival (RFS) were compared in the whole population. A propensity score matching (PSM) analysis and an inverse probability weighting analysis (IPW) were performed to assess the influence of IVC resection on short-and long-terms outcomes. Results: Among the 78 patients who underwent MH, 20 had IVC resection (IVC patients). Overall, the mortality and severe complication rate were 8% and 20%, respectively. IVC patients required more extended hepatectomies (p = 0.001) and had increased rates of transfusions (p = 0.001), however they did not experience increased postoperative morbidity, even after PSM. The 1-, 3-and 5-years OS and DFS were 78%, 45%, and 32% and 48%, 20%, and 16%, respectively. IVC was not associated with decreased OS (p = 0.52) and/or RFS (p = 0.85), even after IPW. Conclusion: MH with IVC resection for ICC seems to provide acceptable short-and long-term results in a selected population of patients.

Automated summary

The research found that performing MH with IVC resection on ICC patients did not significantly impact postoperative survival and recurrence rates, and did not increase the overall complication rate. However, patients who underwent IVC resection required more extensive hepatectomies and had higher rates of blood transfusions.