Perioperative and long-term outcome of intrahepatic cholangiocarcinoma involving the hepatic hilus after curative-intent resection: comparison with peripheral intrahepatic cholangiocarcinoma and hilar cholangiocarcinoma

Surgery ◽  
2018 ◽  
Vol 163 (5) ◽  
pp. 1114-1120 ◽  
Author(s):  
Xu-Feng Zhang ◽  
Fabio Bagante ◽  
Qinyu Chen ◽  
Eliza W. Beal ◽  
Yi Lv ◽  
...  
Keyword(s):  
Intrahepatic Cholangiocarcinoma ◽  
Hilar Cholangiocarcinoma ◽  
Curative Intent ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Hepatic Hilus

scholarly journals The Presence of Small Nerve Fibers in the Tumor Microenvironment as Predictive Biomarker of Oncological Outcome Following Partial Hepatectomy for Intrahepatic Cholangiocarcinoma

Cancers ◽  
2021 ◽  
Vol 13 (15) ◽  
pp. 3661
Author(s):  
Jan Bednarsch ◽  
Xiuxiang Tan ◽  
Zoltan Czigany ◽  
Dong Liu ◽  
Sven Arke Lang ◽  
...  
Keyword(s):  
Tumor Microenvironment ◽  
Intrahepatic Cholangiocarcinoma ◽  
Cox Regression ◽  
Oncological Outcome ◽  
Nerve Fibers ◽  
Nodal Metastases ◽  
Cancer Specific Survival ◽  
Curative Intent ◽  
Term Outcome ◽  
Long Term Outcome

The oncological role of the density of nerve fibers (NFs) in the tumor microenvironment (TME) in intrahepatic cholangiocarcinoma (iCCA) remains to be determined. Therefore, data of 95 iCCA patients who underwent hepatectomy between 2010 and 2019 was analyzed regarding NFs and long-term outcome. Extensive group comparisons were carried out and the association of cancer-specific survival (CSS) and recurrence-free survival (RFS) with NFs were assessed using Cox regression models. Patients with iCCA and NFs showed a median CSS of 51 months (5-year-CSS = 47%) compared to 27 months (5-year-CSS = 21%) in patients without NFs (p = 0.043 log rank). Further, NFs (hazard ratio (HR) = 0.39, p = 0.002) and N-category (HR = 2.36, p = 0.010) were identified as independent predictors of CSS. Patients with NFs and without nodal metastases displayed a mean CSS of 89 months (5-year-CSS = 62%), while patients without NFs or with nodal metastases but not both showed a median CCS of 27 months (5-year-CSS = 25%) and patients with both positive lymph nodes and without NFs showed a median CCS of 10 months (5-year-CSS = 0%, p = 0.001 log rank). NFs in the TME are, therefore, a novel and important prognostic biomarker in iCCA patients. NFs alone and in combination with nodal status is suitable to identify iCCA patients at risk of poor oncological outcomes following curative-intent surgery.

Adjuvant chemotherapy following curative intent hepatectomy for intrahepatic cholangiocarcinoma: Results from a multi-institutional analysis of 575 patients.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 4110-4110
Author(s):  
Dario Ribero ◽  
Antonio Daniele Pinna ◽  
Gennaro Nuzzo ◽  
Alfredo Guglielmi ◽  
Luca Aldrighetti ◽  
...  
Keyword(s):  
Adjuvant Chemotherapy ◽  
Intrahepatic Cholangiocarcinoma ◽  
Cox Regression ◽  
Radical Resection ◽  
Continuous Variable ◽  
Outcome Data ◽  
Curative Intent ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Cox Regression Analysis

4110 Background: Surgical resection alone is the standard of care for patients with resectable intrahepatic cholangiocarcinoma (IHC). This study evaluates the benefit of adjuvant chemotherapy (AdjCTx) following curative intent hepatectomy for IHC. Methods: Clinicopathologic and long-term outcome data of 575 consecutive patients treated with curative intent hepatectomy for IHC (1995-2011) were extracted from a multi-institutional registry. After excluding operative mortality and M1 (n=46), Cox regression analysis was used to identify independent determinants of early recurrence (i.e., within 3 years). Propensity scores, which are used in observational studies to reduce selection bias by equating groups on the basis of relevant covariates, were calculated and utilized to match patients who had or had not AdjCTx (one-to-one match). Cases whose propensity score deviated more than 0.10 were considered unmatched and excluded from the analysis. Primary end-point was recurrence-free survival (RFS) at 3-years. Results: At a median FU of 42 months, 247 patients had recurred. Predictors of recurrence were LN metastases (HR 1.83 [1.36-2.44]), radical resection (HR 0.64 [0.45-0.9]), an elevated preoperative CA19.9 (HR 1.54 [1.15-2.07]), vascular invasion (HR 1.97 [1.49-2.61]), multiple tumors (HR 2.21 [1.71-2.86]), and size (analysed as continuous variable) (HR 1.01 [1.01-1.01]). After matching, no difference was observed between patients who had or had not AdjCTx (n=155 per group; 3-yrs RFS 28.3% vs. 38.0%, respectively; p=NS). When the analysis was restricted to patients who had gemcitabine, GEMOX or FOLFOX for 3 or more cycles (n=64 per group) again no difference emerged between patients who had or had not AdjCTx (3-yrs RFS 27.7% vs. 40.0% respectively, p=NS ). Conclusions: Our data suggest that AdjCTx following resection of IHC does not increase 3-years RFS.

scholarly journals Impact of Morphological Status on Long-Term Outcome Among Patients Undergoing Liver Surgery for Intrahepatic Cholangiocarcinoma

2017 ◽  
Vol 24 (9) ◽  
pp. 2491-2501 ◽  
Author(s):  
Fabio Bagante ◽  
Gaya Spolverato ◽  
Matthew Weiss ◽  
Sorin Alexandrescu ◽  
Hugo P. Marques ◽  
...  
Keyword(s):  
Intrahepatic Cholangiocarcinoma ◽  
Liver Surgery ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Morphological Status

Impact of portal vein resection on oncologic long-term outcome in patients with hilar cholangiocarcinoma

Surgery ◽  
2015 ◽  
Vol 158 (5) ◽  
pp. 1252-1260 ◽  
Author(s):  
Katrin Hoffmann ◽  
Stephan Luible ◽  
Benjamin Goeppert ◽  
Karl-Heinz Weiss ◽  
Ulf Hinz ◽  
...  
Keyword(s):  
Portal Vein ◽  
Hilar Cholangiocarcinoma ◽  
Portal Vein Resection ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Vein Resection

Resectable Hilar Cholangiocarcinoma: Surgical Treatment and Long-Term Outcome

Surgery Today ◽  
2004 ◽  
Vol 34 (11) ◽  
pp. 885-890 ◽  
Author(s):  
Michael I. D’Angelica ◽  
William R. Jarnagin ◽  
Leslie H. Blumgart
Keyword(s):  
Surgical Treatment ◽  
Hilar Cholangiocarcinoma ◽  
Term Outcome ◽  
Long Term Outcome

Regarding: Impact of portal vein resection on oncologic long-term outcome in patients with hilar cholangiocarcinoma

Surgery ◽  
2016 ◽  
Vol 159 (3) ◽  
pp. 986-987
Author(s):  
Moritz Schmelzle ◽  
Robert Sucher ◽  
Daniel Seehofer ◽  
Johann Pratschke
Keyword(s):  
Portal Vein ◽  
Hilar Cholangiocarcinoma ◽  
Portal Vein Resection ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Vein Resection

scholarly journals Proposal of a New Definition of “Very Early” Intrahepatic Cholangiocarcinoma—A Retrospective Single-Center Analysis

2021 ◽  
Vol 10 (18) ◽  
pp. 4073
Author(s):  
Oliver Beetz ◽  
Angelica Timrott ◽  
Clara A. Weigle ◽  
Andreas Schroeter ◽  
Sebastian Cammann ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Intrahepatic Cholangiocarcinoma ◽  
Tumor Size ◽  
Tumor Biology ◽  
Extrahepatic Disease ◽  
Term Outcome ◽  
Term Survival ◽  
Long Term Outcome ◽  
Definition Of

Intrahepatic cholangiocarcinoma (ICC) is a rare disease with poor outcome, despite advances in surgical and non-surgical treatment. Recently, studies have reported a favorable long-term outcome of “very early” ICC (based on tumor size and absence of extrahepatic disease) after hepatic resection and liver transplantation, respectively. However, the prognostic value of tumor size and a reliable definition of early disease remain a matter of debate. Patients undergoing resection of histologically confirmed ICC between February 1996 and January 2021 at our institution were reviewed for postoperative morbidity, mortality, and long-term outcome after being retrospectively assigned to two groups: “very early” (single tumor ≤ 3 cm) and “advanced” ICC (size > 3 cm, multifocality or extrahepatic disease). A total of 297 patients were included, with a median follow-up of 22.8 (0.1–301.7) months. Twenty-one (7.1%) patients underwent resection of “very early” ICC. Despite the small tumor size, major hepatectomies (defined as resection of ≥3 segments) were performed in 14 (66.7%) cases. Histopathological analyses revealed lymph node metastases in 5 (23.8%) patients. Patients displayed excellent postoperative outcome compared to patients with “advanced” disease: intrahospital mortality was not observed, and patients displayed superior long-term survival, with a 5-year survival rate of 58.2% (versus 24.3%) and a median postoperative survival of 62.1 months (versus 25.3 months; p = 0.013). In conclusion, although the concept of a “very early” ICC based solely on tumor size is vague as it does not necessarily reflect an aggressive tumor biology, our proposed definition could serve as a basis for further studies evaluating the efficiency of either surgical resection or liver transplantation for this malignant disease.

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