Abstract: Objective To analyze the influence of lymphatic, vascular and nerve invasion on postoperative recurrence and survival of patients with intrahepatic cholangiocarcinoma (ICC).Methods One hundred and forty-two ICC patients collected from January 2008 to June 2016 were retrospectively analyzed. There were 74 males and 68 females patients with an average age of 63 (56, 74) years. The diagnosis of ICC was confirmed by pathology after hepatectomy. The clinical data of the ICC patients with different lymphatic, vascular and nerve invasion states were analyzed, alone with their recurrence-free survival rate and survival rate. T-test and Chi-square test were used for statistical comparisons according to the data types. The recurrence-free survival rate and survival rate were compared by KM method and log-rank test.Results In the ICC patients, there were 40 cases with and 102 cases without lymphatic invasion. There were 15 cases (37.5%), 19 cases (47.5%) and 11 cases (27.5%) of vascular, nerve and visceral invasion in patients with lymphatic invasion, respectively, which were significantly different from those without lymphatic invasion [3 cases (3.0%), 4 cases (3.9%) and 8 cases (7.8%), respectively] (P<0.05). In ICC patients, there were 18 cases with vascular and 124 cases without vascular invasion. The T1/T2, T3/T4 staging of patients with vascular invasion was 10 cases (55.6%) and 8 cases (44.4%), while the T1/T2, T3/T4 staging of patients without vascular invasion was 97 cases (78.2%) and 27 cases (21.8%), respectively, with statistical significance (P<0.05). Among the patients with vascular invasion, 10 cases (55.6%) had lymphatic invasion and 12 cases (66.7%) had nerve invasion, which was significantly different from those without vascular invasion [(30 cases (24.0%) and 11 cases (8.9%), respectively) (P<0.05). In ICC patients, there were 23 cases with and 119 cases without nerve invasion. There were 12 cases (52.2%) of lymphatic invasion and 7 cases (30.5%) of vessel invasion in the nerve invasion patients, which were significantly different from those without nerve invasion [38 cases (23.5%) and 11 cases (9.3%), respectively) (P<0.05). There was no significant difference in the recurrence-free survival rates among ICC patients with different lymphatic, vascular and nerve invasion states at 1, 3 and 5 years after operation (P>0.05). The 1-year, 3-year and 5-year overall survival rates of ICC patients with nerve invasion were 73.9% (17/23), 21.7% (5/23) and 0 (0/23), while those without nerve invasion were 79.8% (95/119), 34.4% (41/119) and 27 cases (22.7%), respectively, with statistical significance (P<0.05).Conclusion The overall survival rate of ICC patients with nerve invasion is poor, while the recurrence-free survival rates and overall survival rates of patients with different lymphatic and vascular states have no significant difference.

Key words: Intrahepatic cholangiocarcinoma, Nerves invasion, Overall survival rate