Very Early Recurrence Following Liver Resection for Intrahepatic Cholangiocarcinoma: Is It Predictable by Clinical Preoperative Factors?

Background: Approximately one-quarter of patients undergoing resection for intrahepatic cholangiocarcinoma (ICC) experience very early recurrence (within 6 months after liver resection), which is associated with a poor prognosis. Identifying factors associated with very early recurrence may help optimize patient selection for surgery and avoid futile, high-risk hepatectomies. The aim of this study was to assess whether preoperative clinical factors alone can reliably predict very early recurrence following curative liver resection for ICC. Methods: A retrospective analysis was conducted on 83 patients who underwent liver resection between 2010 and 2020. Results: The 5-year overall survival (OS) rate for the entire cohort was 51.4%. Recurrence occurred in 54 patients (65.1%), with 17 (20.5%) experiencing very early recurrence. The 5-year OS for patients with very early recurrence was significantly lower than for those without it (0% vs. 48.7%, respectively; p = 0.013). Preoperative clinical prognostic factors failed to identify patients at high risk of very early recurrence, which occurred in 21% of patients classified as low risk. Conclusions: Preoperative clinical factors alone are insufficient for accurate risk stratification. Integrating clinicopathological data with molecular classifications of ICC is urgently needed to enable a more personalized oncological approach for these patients.