Impact of tumor localization on the outcomes of surgery for an intrahepatic cholangiocarcinoma
Background Intrahepatic cholangiocarcinoma (ICC) shows differing clinical outcomes depending on its localization. Methods We reviewed the surgical outcomes of 104 ICC patients who underwent liver resection at our institution. We divided ICC into hilar type (HICC) and peripheral type (PICC) depending...
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Published in | Journal of gastroenterology Vol. 53; no. 11; pp. 1206 - 1215 |
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Main Authors | , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Tokyo
Springer Japan
01.11.2018
Springer Springer Nature B.V |
Subjects | |
Online Access | Get full text |
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Summary: | Background
Intrahepatic cholangiocarcinoma (ICC) shows differing clinical outcomes depending on its localization.
Methods
We reviewed the surgical outcomes of 104 ICC patients who underwent liver resection at our institution. We divided ICC into hilar type (HICC) and peripheral type (PICC) depending on positive contact with the hepatic hilum on preoperative computed tomography (CT).
Results
The survival outcomes were significantly poorer in HICC patients. HICCs showed a larger tumor size and more frequent bile duct invasion, lymph node metastasis, and non-curative resection than PICC. Resections for HICC had greater blood loss and required a longer operation time, larger hepatectomy, and more frequent extrahepatic bile duct resection. HICCs, even if small in size, also showed a greater tendency to metastasize to the lymph nodes of the hepatoduodenal ligament. Univariate analysis of the ICCs in our current cohort revealed that tumor size, multiple tumors, bile duct invasion, lymph node metastasis, non-curative resection, and HICC are associated with a poorer overall survival outcome. Multivariate analysis indicated that multiple tumors and non-curative resection were independent prognostic factors for survival. Among the curative resection cases, however, survival did not differ significantly between HICC and PICC. The accuracy rate of our CT-based classification for the pathological classification was 81.7%.
Conclusions
HICC shows more frequent bile duct invasion and lymph node metastasis, requires more extensive surgery, and has a higher rate of non-curative resection than PICC. However, if curative resection is achieved, the survival outcomes are expected to be equivalent between HICC and PICC. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 0944-1174 1435-5922 |
DOI: | 10.1007/s00535-018-1469-8 |