Introduction : Recurrence of intrahepatic cholangiocarcinoma (ICC) after curative resection is common and the prognosis of recurrent ICC is dismal.

Methods : This study was designed to investigate the risk factors and prognosis after disease recurrence following curative-intent resection for ICC.

Results : A total of 147 patients were included. With a median follow-up of 21 months, 101 patients (68.7%) experienced ICC recurrence. On multivariate analysis, rim-enhanced or hypovascular mass on late arterial phase of CT image (hazard ratio [HR] 3.893, 95% confidence interval [CI] 1.700-8.915; p = 0.0013 and HR 6.241, 95% CI 2.670-14.586, p < 0.001, respectively), macrovascular invasion (HR 0.518, 95% CI 0.280-0.960; p = 0.037), microvascular invasion (HR 1.813, 95% CI 1.134-2.900, p = 0.013), advanced T stage ( HR 1.801, 95% CI 1.105-2.934, p = 0.018), and Lymph node metastasis (HR 2.067, 95% CI 1.168-3.657, p = 0.013) were associated with recurrence of ICC following curative resection, independently. Median survival after recurrence was better among patients who tried any treatment modality (18.5 months) than patients who did not received treatment (5.0 months) [p < 0.001].

Conclusions : Several factors including preoperative vascularity of ICC on CT image are the independent risk factors for recurrence of ICC after curative resection. Proactive treatment for recurrent ICC can be helpful to prolong the survival length of patients with recurrent ICC.