Repeated liver resections for recurrent intrahepatic cholangiocarcinoma.

Objective: To evaluate the safety and advisability of repeated liver resection (RLR) for recurrent intrahepatic cholangiocarcinoma (ICC).

Material And Methods: The results of RLR for ICC recurrence (=10) were retrospectively analyzed between 1999 and 2023. The control group consisted of patients undergoing primary liver resection for ICC (=195).

Results: Surgery time (=0.001) and blood loss (=0.038) were lower in the RLR group. There were no blood transfusions (0 vs. 31.8%, =0.034) and 90-day mortality (0 vs. 3.2%, =1.0) in the same group. The risk of complications (30.0% vs.45.6%, =0.517) and adverse events grade ≥ III (20.0% vs. 17.9%, =1.0) was similar in both groups. Multifocal intrahepatic nodes were more common in the RLR group (60% vs. 37.9%, =0.193), while there were no negative factors such as lymph nodes involvement (0 vs. 34.4%, =0.032) and invasion of surrounding structures (0 vs. 38.5%, =0.015). Dimensions of the largest node were smaller in repeated resection (2 vs. 8 cm, <0.0001). Incidence of R0 resections (80.0% vs. 82.1%, =1.0) was comparable. Long-term results were similar: five-year overall survival 17.2% and 34.7% (=0.912), three-year disease-free survival 20.0% and 26.5% (=0.421).

Conclusion: Similar results of repeated and primary liver resections confirm advisability of RLR for intrahepatic recurrence of ICC.