Clinicopathological Prognostic Factors After Hepatectomy for Patients with Mass-Forming Type Intrahepatic Cholangiocarcinoma: Relevance of the Lymphatic Invasion Index

Abstract Context.—Colorectal carcinoma is one of the most common types of cancer in Western countries and is consistently ranked among the top 3 causes of cancer-related deaths, with approximately 150 000 new cases in the United States and 55 000 deaths in 2006. The pathologist's assessment of tumor stage and stage-independent morphologic features, such as vascular/lymphatic invasion, influences treatment strategies for the individual patient, such as the decision to offer adjuvant therapy after surgery. However, although the pathologist influences clinical care in colorectal cancer, certain aspects of staging and evaluation of prognostic factors remain challenging and confusing. Objectives.—To present the currently used colorectal cancer staging system; to address challenging areas in pathologic staging, including T category considerations and recommendations for the minimum number of lymph nodes sampled; and to discuss assessment of selected stage-independent prognostic factors, such as vascular/ lymphatic invasion. Data Sources.—This review is based on the current staging manual from the American Joint Committee on Cancer, the College of American Pathologists Protocol for Examination of Specimens From Patients With Primary Carcinomas of the Colon and Rectum, and selected articles pertaining to colorectal carcinoma staging and prognostic factors accessible through Ovid Medline (National Library of Medicine, Bethesda, Md). Conclusions.—Proper assessment of pathologic staging for colorectal cancer and of morphologic prognostic factors requires a thorough understanding of staging guidelines and careful specimen dissection and sampling.

Download Full-text

Prognostic Factors for Overall Survival in Advanced Intrahepatic Cholangiocarcinoma Treated with Yttrium-90 Radioembolization

Journal of Clinical Medicine ◽

10.3390/jcm9010056 ◽

2019 ◽

Vol 9 (1) ◽

pp. 56 ◽

Cited By ~ 3

Author(s):

Michael Köhler ◽

Fabian Harders ◽

Fabian Lohöfer ◽

Philipp M. Paprottka ◽

Benedikt M. Schaarschmidt ◽

...

Keyword(s):

Overall Survival ◽

Prognostic Factors ◽

Liver Disease ◽

Surgical Resection ◽

Intrahepatic Cholangiocarcinoma ◽

Tumor Volume ◽

Cox Regression ◽

Tertiary Care ◽

Liver Volume ◽

Total Liver Volume

Purpose: To evaluate factors associated with survival following transarterial 90Y (yttrium) radioembolization (TARE) in patients with advanced intrahepatic cholangiocarcinoma (ICC). Methods: This retrospective multicenter study analyzed the outcome of three tertiary care cancer centers in patients with advanced ICC following resin microsphere TARE. Patients were included either after failed previous anticancer therapy, including relapse after surgical resection, or for having a minimum of 25% of total liver volume affected by ICC. Patients were stratified and response was assessed by the Response Evaluation Criteria in Solid Tumors (RECIST) criteria at 3 months. Kaplan–Meier analysis was performed to analyze survival followed by cox regression to determine independent prognostic factors for survival. Results: 46 patients were included (19 male, 27 female), median age 62.5 years (range 29–88 years). A total of 65% of patients had undergone previous therapy, while 63% had a tumor volume > 25% of the entire liver volume. Median survival was 9.5 months (95% CI: 6.1–12.9 months). Due to loss in follow-up, n = 37 patients were included in the survival analysis. Cox regression revealed the extent of liver disease to one or both liver lobes being associated with survival, irrespective of tumor volume (p = 0.041). Patients with previous surgical resection of ICC had significantly decreased survival (3.9 vs. 12.8 months, p = 0.002). No case of radiation-induced liver disease was observed. Discussion: Survival after 90Y TARE in patients with advanced ICC primarily depends on disease extent. Only limited prognostic factors are associated with a general poor overall survival.

Download Full-text

Number of positive lymph nodes and lymphatic invasion are significant prognostic factors after pancreaticoduodenectomy for distal cholangiocarcinoma

Clinical and Experimental Gastroenterology ◽

10.2147/ceg.s207333 ◽

2019 ◽

Vol Volume 12 ◽

pp. 255-262 ◽

Cited By ~ 2

Author(s):

Shuji Suzuki ◽

Mitsugi Shimoda ◽

Jiro Shimazaki ◽

Tsunehiko Maruyama ◽

Yukio Oshiro ◽

...

Keyword(s):

Prognostic Factors ◽

Lymph Nodes ◽

Lymphatic Invasion ◽

Distal Cholangiocarcinoma ◽

Positive Lymph Nodes

Download Full-text

The MEGNA Score and Preoperative Anemia are Major Prognostic Factors After Resection in the German Intrahepatic Cholangiocarcinoma Cohort

Annals of Surgical Oncology ◽

10.1245/s10434-019-07968-7 ◽

2019 ◽

Vol 27 (4) ◽

pp. 1147-1155 ◽

Cited By ~ 3

Author(s):

Andreas A. Schnitzbauer ◽

Johannes Eberhard ◽

Fabian Bartsch ◽

Stefan M. Brunner ◽

Güralp O. Ceyhan ◽

...

Keyword(s):

Prognostic Factors ◽

Intrahepatic Cholangiocarcinoma ◽

Preoperative Anemia

Download Full-text

Preoperative leukocytosis and the resection severity index are independent risk factors for survival in patients with intrahepatic cholangiocarcinoma

Langenbeck s Archives of Surgery ◽

10.1007/s00423-020-01962-4 ◽

2020 ◽

Vol 405 (7) ◽

pp. 977-988

Author(s):

Oliver Beetz ◽

Clara A. Weigle ◽

Sebastian Cammann ◽

Florian W. R. Vondran ◽

Kai Timrott ◽

...

Keyword(s):

Risk Factors ◽

Prognostic Factors ◽

Postoperative Complications ◽

Intrahepatic Cholangiocarcinoma ◽

Postoperative Morbidity ◽

Severity Index ◽

The Body ◽

Morbidity And Mortality ◽

Independent Risk Factors ◽

Risk Factors For Survival

Abstract Purpose The incidence of intrahepatic cholangiocarcinoma is increasing worldwide. Despite advances in surgical and non-surgical treatment, reported outcomes are still poor and surgical resection remains to be the only chance for long-term survival of affected patients. The identification and validation of prognostic factors and scores, such as the recently introduced resection severity index, for postoperative morbidity and mortality are essential to facilitate optimal therapeutic regimens. Methods This is a retrospective analysis of 269 patients undergoing resection of histologically confirmed intrahepatic cholangiocarcinoma between February 1996 and September 2018 at a tertiary referral center for hepatobiliary surgery. Regression analyses were performed to evaluate potential prognostic factors, including the resection severity index. Results Median postoperative follow-up time was 22.93 (0.10–234.39) months. Severe postoperative complications (≥ Clavien-Dindo grade III) were observed in 94 (34.9%) patients. The body mass index (p = 0.035), the resection severity index (ASAT in U/l divided by Quick in % multiplied by the extent of liver resection graded in points; p = 0.006), additional hilar bile duct resection (p = 0.005), and number of packed red blood cells transfused during operation (p = 0.036) were independent risk factors for the onset of severe postoperative complications. Median Kaplan-Meier survival after resection was 27.63 months. Preoperative leukocytosis (p = 0.003), the resection severity index (p = 0.005), multivisceral resection (p = 0.001), and T stage ≥ 3 (p = 0.013) were identified as independent risk factors for survival. Conclusion Preoperative leukocytosis and the resection severity index are useful variables for preoperative risk stratification since they were identified as significant predictors for postoperative morbidity and mortality, respectively.

Download Full-text

Retrospective Analysis of Prognostic Factors after Liver Transplantation for Intrahepatic Cholangiocarcinoma in China: A Single-Center Experience

Hepatogastroenterology ◽

10.5754/hge10704 ◽

2011 ◽

Vol 58 (109) ◽

pp. 1255-1259 ◽

Cited By ~ 10

Author(s):

Xiao-Xing Hu ◽

Lu-Nan Yan

Keyword(s):

Liver Transplantation ◽

Prognostic Factors ◽

Retrospective Analysis ◽

Intrahepatic Cholangiocarcinoma ◽

Single Center ◽

Single Center Experience

Download Full-text

Surveillance for stage I testicular seminoma: Retrospective analysis of prognostic factors for relapse at a single institution in Japan

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.15630 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 15630-15630

Author(s):

K. Kakimoto ◽

Y. Ono ◽

N. Meguro ◽

A. Kawashima ◽

T. Kinouchi ◽

...

Keyword(s):

Prognostic Factors ◽

Survival Rate ◽

Vascular Invasion ◽

Lymphatic Invasion ◽

Rete Testis ◽

Stage I ◽

Single Institution ◽

Testicular Seminoma ◽

Beta Hcg ◽

Stage I Seminoma

15630 Background: Treatment options for clinical stage I seminoma include adjuvant radiotherapy (RT) as well as surveillance and adjuvant chemotherapy. Although adjuvant RT remains the treatment of choice in most centers, the success of surveillance of patients with stage I nonseminomatous germ cell tumors and the establishment of curative chemotherapy for advanced disease have led to re-examination of the standard treatment approach. Data available from the surveillance and adjuvant RT series suggest that nearly 100% of patients with stage I testicular seminoma are cured, whichever approach is chosen. We report here results of a retrospective analysis of prognostic factors for stage I testicular seminoma. Methods: Between January 1980 and December 2004, surveillance was performed for 61 patients. Tumor characteristics (age at diagnosis, size, elevation of beta hCG level, invasion of the rete testis, vascular invasion, and lymphatic invasion) were examined as factors possibly predictive of relapse. Cause-specific survival rate was calculated using the Kaplan-Meier method. Results: With a median follow-up of 10.5 years (range, 2.35–20.8 years), 7 relapses were observed, with an actuarial 5- year relapse-free rate (RFR) of 89.2%. On univariate analysis, only tumor size (RFR: <8cm, 96%; =8cm, 76%; p=0.029) was predictive of relapse. Age at diagnosis (RFR: <36, 89%; =36, 91%), elevation of beta hCG level (RFR: 93% [normal] v 91% [elevated]), invasion of the rete testis (RFR:92% [absent] v 90% [present]), vascular invasion (RFR:89% [absent] v 86% [present]), and lymphatic invasion (RFR: 89% [absent] v 78% [present]) were not predictive of relapse. The overall relapse rate was 11.5%. Overall 5-year survival rate was 97%. Conclusions: Size of primary tumor was found to be predictive of relapse in patients with stage I seminoma managed with surveillance, on analysis at a single institution in Japan. No significant financial relationships to disclose.

Download Full-text

Survival time and its prognostic factors in advanced unresected cholangiocarcinoma without chemoradiation

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.e15681 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. e15681-e15681

Author(s):

J. Park ◽

M. Kim ◽

J. Kim ◽

J. Lee

Keyword(s):

Multivariate Analysis ◽

Prognostic Factors ◽

Survival Time ◽

Intrahepatic Cholangiocarcinoma ◽

Hilar Cholangiocarcinoma ◽

Treatment Method ◽

Control Groups ◽

Future Studies ◽

Kaplan Meier ◽

Dismal Prognosis

e15681 Background: To evaluate survival time and its prognostic factors contributing to survival of advanced unresected cholangiocarcinoma. Methods: We reviewed the experience of 330 patients with histologically proven unresected advanced intrahepatic and hilar cholangiocarcinoma and evaluated their survival time and significant prognostic factors. They did not receive any surgery, chemotherapy and radiotherapy and they underwent only palliative nonsurgical biliary drainage if it was needed to relieve biliary obstructive symptom. Results: Survival time of overall cholangiocarcinoma (median±SD) was 3.9±7.8 months; 3±5.3 months for intrahepatic cholangiocarcinoma, 5.9±10.1 months for hilar cholangiocarcinoma. By Kaplan-Meier survival analysis, intrahepatic cholangiocarcinoma patients survived significantly shorter than hilar cholangiocarcinoma patients. By multivariate analysis for intrahepatic cholangiocarcinoma, distant metastasis was independently associated with shorter survival time. Multivariate analysis for hilar cholangiocarcinoma showed initial CEA > 30 ng/dl were independent predictors of shorter survival. Conclusions: Patients with unresectable cholangiocarcinoma who do not undergo surgery, chemotherapy and/or radiotherapy have a dismal prognosis. We hope that the outcome of our study would help clinicians better predict the prognosis of cholangiocarcinoma patients not receiving such aggressive treatments. These data would be used as the comparable data for control groups of future studies to assess the outcome of newly designed or developed treatment method. No significant financial relationships to disclose.

Download Full-text