Impact of systemic inflammation on outcome following resection for intrahepatic cholangiocarcinoma

Aims: To analyse the results and prognostic factors affecting disease-free and overall survival following potentially curative resection for intrahepatic cholangiocarcinoma (IHCC). Methods: Patients undergoing resection for IHCC from January 1996 to December 2006 were included. Data analysed included demographics, clinical and histopathology data. Results: Twenty-seven patients were identified with a median age of 57 (32-84) years. The 1-, 3- and 5-year overall and disease-free survival rates were 74%, 16% and 16%, and 44%, 15% and 15%, respectively. On univariate analysis, age <65 years, female gender, neutrophil to lymphocyte ratio (NLR) >= 5, micro-vascular invasion and lymph node involvement were predictors of poorer overall survival. Multivariate analysis did not identify any independent predictors of overall survival. A NLR >= 5 was the only adverse predictor of disease-free survival. The median disease-free survival of patients with NLR >= 5 was 6 months compared to 18 months for those with NLR < 5. There was a significant association between patients with a NLR >= 5 and larger turnout size, satellite lesions, micro-vascular invasion and lymph node involvement. Conclusion: Long-term outcome following resection of IHCC is poor. A pre-operative NLR >= 5 was an adverse predictor of disease-free survival and was associated with an aggressive tumour biology profile.