Prognostic value of lymphovascular invasion in Bismuth-Corlette type IV hilar cholangiocarcinoma.

AIM

To assess the prognostic value of lymphovascular invasion (LVI) in Bismuth-Corlette type IV hilar cholangiocarcinoma (HC) patients.

METHODS

A retrospective analysis was performed on 142 consecutively recruited type IV HC patients undergoing radical resection with at least 5 years of follow-up. Survival analysis was performed by the Kaplan-Meier method, and the association between the clinicopathologic variables and survival was evaluated by log-rank test. Multivariate analysis was adopted to identify the independent prognostic factors for overall survival (OS) and disease-free survival (DFS). Multiple logistic regression analysis was performed to determine the association between LVI and potential variables.

RESULTS

LVI was confirmed histopathologically in 29 (20.4%) patients. Multivariate analysis showed that positive resection margin (HR = 6.255, 95%CI: 3.485-11.229, < 0.001), N1 stage (HR = 2.902, 95%CI: 1.132-7.439, = 0.027), tumor size > 30 mm (HR = 1.942, 95%CI: 1.176-3.209, = 0.010) and LVI positivity (HR = 2.799, 95%CI: 1.588-4.935, < 0.001) were adverse prognostic factors for DFS. The independent risk factors for OS were positive resection margin (HR = 6.776, 95%CI: 3.988-11.479, < 0.001), N1 stage (HR = 2.827, 95%CI: 1.243-6.429, = 0.013), tumor size > 30 mm (HR = 1.739, 95%CI: 1.101-2.745, = 0.018) and LVI positivity (HR = 2.908, 95%CI: 1.712-4.938, < 0.001). LVI was associated with N1 stage and tumor size > 30 mm. Multiple logistic regression analysis indicated that N1 stage (HR = 3.312, 95%CI: 1.338-8.198, = 0.026) and tumor size > 30 mm (HR = 3.258, 95%CI: 1.288-8.236, = 0.013) were associated with LVI.

CONCLUSION

LVI is associated with N1 stage and tumor size > 30 mm and adversely influences DFS and OS in type IV HC patients.