{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T19:08:32Z","timestamp":1790017712020,"version":"4.0.1"},"reference-count":24,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"9","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Precis Oncol"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>The impact of first recurrence site on outcome after resection of intrahepatic cholangiocarcinoma (IHC) is ill-defined, as are the genomic underpinnings of recurrence and outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Resected patients with IHC at two institutions with genomic data were included. Sites of first recurrence (SOFR) were classified as liver only (LO), extrahepatic (EH) only, or simultaneous liver and extrahepatic (SIM). Overall survival (OS) was calculated from the time of recurrence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Between 1993 and 2021, 318 patients met inclusion criteria; 232 (73%) recurred. SOFR were LO = 93 (40%), EH = 80 (34%), and SIM = 59 (26%). Median OS from recurrence was similar in the LO (33 [26, 42] months) and EH groups (33 [23, 46] months) but much lower in SIM (12 [9.8, 18] months;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001). Moderate\/poor tumor differentiation, lymphovascular invasion, N1 disease, perineural invasion, and time to recurrence (all\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .05) were associated with SIM; only positive resection margin predicted LO (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .007). No individual genomic or pathway alterations predicted SOFR; however, for all recurrers, TP53\n                      <jats:italic toggle=\"yes\">mut<\/jats:italic>\n                      (n = 51, 22%; hazard ratio [HR], 2.0 [1.4 to 2.9];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .002), CDKN2A\n                      <jats:italic toggle=\"yes\">del<\/jats:italic>\n                      (n = 34, 15%; HR, 3.4 [95% CI, 2.2 to 5.3];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001), CDKN2B (n = 25, 11%; HR, 3.2 [95% CI, 2.0 to 5.0];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001), and KRAS\n                      <jats:italic toggle=\"yes\">mut<\/jats:italic>\n                      (n = 25, 11%; HR, 2.5 [95% CI, 1.6 to 4.0];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .002) were associated with worse OS. On multivariable analysis, SIM (HR, 2.5 [95% CI, 1.7 to 3.5];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001), N1 status (HR, 1.8 [95% CI, 1.2 to 2.6];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .004), and alterations in the high-risk genotype (TP53\n                      <jats:italic toggle=\"yes\">mut<\/jats:italic>\n                      , CDKN2A\n                      <jats:italic toggle=\"yes\">del<\/jats:italic>\n                      or KRAS\n                      <jats:italic toggle=\"yes\">mut<\/jats:italic>\n                      ; n = 84, 36%; HR, 2.4 [95% CI, 1.7 to 3.3];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001) were independent predictors of poor OS.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Recurrence after resection of IHC is common, and the liver was the most common site (66%). Clinicopathologic and genomic factors had limited ability to predict SOFR. Although LO and EH were associated with similar OS, SIM recurrences had dramatically worse OS. Adjuvant strategies targeting liver recurrence may improve outcomes after resection of IHC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/po-25-00402","type":"journal-article","created":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T19:59:08Z","timestamp":1761249548000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":3,"title":["Intrahepatic Cholangiocarcinoma: Recurrence Patterns, Genomics, and Survival"],"prefix":"10.1200","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-1243-4865","authenticated-orcid":true,"given":"Pratik","family":"Chandra","sequence":"first","affiliation":[{"name":"Department of Surgery, Hepatopancreatobiliary Service, Memorial Sloan Kettering Cancer Center, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0125-6019","authenticated-orcid":true,"given":"Yi","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Surgery, Hepatopancreatobiliary Service, Memorial Sloan Kettering Cancer Center, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3315-4538","authenticated-orcid":true,"given":"Esther","family":"Drill","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2505-959X","authenticated-orcid":true,"given":"Alice C.","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Surgery, Hepatopancreatobiliary Service, Memorial Sloan Kettering Cancer Center, New York, NY"},{"name":"Weill Medical School at Cornell University, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0929-9542","authenticated-orcid":true,"given":"Nancy","family":"Kemeny","sequence":"additional","affiliation":[{"name":"Weill Medical School at Cornell University, New York, NY"},{"name":"Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5054-8192","authenticated-orcid":true,"given":"Andrea","family":"Cercek","sequence":"additional","affiliation":[{"name":"Weill Medical School at Cornell University, New York, NY"},{"name":"Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3193-4629","authenticated-orcid":true,"given":"Louise","family":"Connell","sequence":"additional","affiliation":[{"name":"Weill Medical School at Cornell University, New York, NY"},{"name":"Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7029-4310","authenticated-orcid":true,"given":"James","family":"Harding","sequence":"additional","affiliation":[{"name":"Weill Medical School at Cornell University, New York, NY"},{"name":"Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1522-8054","authenticated-orcid":true,"given":"Ghassan","family":"Abou-Alfa","sequence":"additional","affiliation":[{"name":"Weill Medical School at Cornell University, New York, NY"},{"name":"Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY"},{"name":"Trinity Dublin University, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8006-3102","authenticated-orcid":true,"given":"Wungki","family":"Park","sequence":"additional","affiliation":[{"name":"Weill Medical School at Cornell University, New York, NY"},{"name":"Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. 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