Skip to main content
Erschienen in: Annals of Surgical Oncology 7/2008

01.07.2008 | Hepatic and Pancreatic Tumors

Intrahepatic Cholangiocarcinoma and Combined Hepatocellular-Cholangiocarcinoma: A Western Experience

verfasst von: Nazario Portolani, MD, Gian Luca Baiocchi, MD, Arianna Coniglio, MD, Tullio Piardi, MD, Luigi Grazioli, MD, Anna Benetti, MD, Andrea Ferrari Bravo, MD, Stefano Maria Giulini, MD

Erschienen in: Annals of Surgical Oncology | Ausgabe 7/2008

Einloggen, um Zugang zu erhalten

Abstract

Background

Intrahepatic cholangiocarcinoma (ICC) is an unusual tumour.

Methods

The clinicopathological data of 67 patients with ICC and combined hepatocellular–cholangiocarcinoma (HCC–ICC) are presented.

Results

HCV–HBV infection was present in 37.3% and chronic liver disease in 38.7% of cases, a rate higher than in the normal population; in these patients the cancer was small, often asymptomatic and of combined type. Liver resection was performed in 51 patients; at 1, 3 and 5 years, overall survival was 87.9%, 59.0%, and disease-free survival was 47.7% and 78.8%, 51.4%, and 46.7%, respectively. The better results were in the group of cirrhotic patients in whom ICC was diagnosed by a screening program for HCC (5-year survival 76.6%). Nodal metastasis showed negative prognostic value for both overall and disease-free survival; in N+ patients mean survival was 14.7 months after liver resection and lymph node dissection.

Conclusion

Viral infection and cirrhosis may be considered risk conditions for ICC and combined HCC–ICC; in resected patients survival was good. Nodal metastases must not be considered a contraindication for liver resection.
Literatur
1.
Zurück zum Zitat Ohtsuka M, Ito H, Kimura F, et al. Results of surgical treatment for intrahepatic cholangiocarcinoma and clinicopathological factors influencing survival. Br J Surg 2002; 89:1525–31PubMedCrossRef Ohtsuka M, Ito H, Kimura F, et al. Results of surgical treatment for intrahepatic cholangiocarcinoma and clinicopathological factors influencing survival. Br J Surg 2002; 89:1525–31PubMedCrossRef
2.
Zurück zum Zitat Okuda K, Nakanuma Y, Miyazaki M. Cholangiocarcinoma: Recent progress. Part 1: Epidemiology and etiology. J Gastroenterol Hepatol 2002; 17:1049–55PubMedCrossRef Okuda K, Nakanuma Y, Miyazaki M. Cholangiocarcinoma: Recent progress. Part 1: Epidemiology and etiology. J Gastroenterol Hepatol 2002; 17:1049–55PubMedCrossRef
3.
Zurück zum Zitat Weber SM, Jarnagin WR, Klimstra D, et al. Intrahepatic cholangiocarcinoma: resectability, recurrence pattern, and outcomes. J Am Coll Surg 2001; 193:134–41CrossRef Weber SM, Jarnagin WR, Klimstra D, et al. Intrahepatic cholangiocarcinoma: resectability, recurrence pattern, and outcomes. J Am Coll Surg 2001; 193:134–41CrossRef
4.
Zurück zum Zitat Huang JL, Biehl TR, Lee FT, et al. Outcomes after resection of cholangiocellular carcinoma. Am J Surg 2004; 87:612–7CrossRef Huang JL, Biehl TR, Lee FT, et al. Outcomes after resection of cholangiocellular carcinoma. Am J Surg 2004; 87:612–7CrossRef
5.
Zurück zum Zitat Kim H, Park C, Han KH, et al. Primary liver carcinoma of intermediate (hepatocyte-cholangiocyte) phenotype. J Hepatol 2004; 40:298–304PubMedCrossRef Kim H, Park C, Han KH, et al. Primary liver carcinoma of intermediate (hepatocyte-cholangiocyte) phenotype. J Hepatol 2004; 40:298–304PubMedCrossRef
6.
Zurück zum Zitat Nakamura S, Suzuki S, Sakaguchi T, et al. Surgical treatment of patients with mixed hepatocellular carcinoma and cholangiocarcinoma. Cancer 1996; 78:1671–6PubMedCrossRef Nakamura S, Suzuki S, Sakaguchi T, et al. Surgical treatment of patients with mixed hepatocellular carcinoma and cholangiocarcinoma. Cancer 1996; 78:1671–6PubMedCrossRef
7.
Zurück zum Zitat Ng IO, Shek TW, Nicholls J, et al. Combined hepatocellular-cholangiocarcinoma: a clinicopathological study. J Gastroenterol Hepatol 1998; 13:34–40PubMedCrossRef Ng IO, Shek TW, Nicholls J, et al. Combined hepatocellular-cholangiocarcinoma: a clinicopathological study. J Gastroenterol Hepatol 1998; 13:34–40PubMedCrossRef
8.
Zurück zum Zitat Taguchi J, Nakashima O, Tanaka M, et al. A clinicopathological study on combined hepatocellular and cholangiocarcinoma. J Gastroenterol Hepatol 1996; 11:758–64PubMedCrossRef Taguchi J, Nakashima O, Tanaka M, et al. A clinicopathological study on combined hepatocellular and cholangiocarcinoma. J Gastroenterol Hepatol 1996; 11:758–64PubMedCrossRef
9.
Zurück zum Zitat Jarnagin WR, Weber S, Tickoo SK, et al. Combined hepatocellular and cholangiocarcinoma: demographic, clinical, and prognostic factors. Cancer 2002; 94:2040–6PubMedCrossRef Jarnagin WR, Weber S, Tickoo SK, et al. Combined hepatocellular and cholangiocarcinoma: demographic, clinical, and prognostic factors. Cancer 2002; 94:2040–6PubMedCrossRef
10.
Zurück zum Zitat Cazals-Hatem D, Rebouissou S, Bioulac-Sage P, et al. Clinical and molecular analysis of combined hepatocellular-cholangiocarcinomas. J Hepatol 2004; 41:292–8PubMedCrossRef Cazals-Hatem D, Rebouissou S, Bioulac-Sage P, et al. Clinical and molecular analysis of combined hepatocellular-cholangiocarcinomas. J Hepatol 2004; 41:292–8PubMedCrossRef
11.
Zurück zum Zitat Green FL (ed.) AJCC cancer staging manual, 6th edn. New York: Springer Verlag, 2002 Green FL (ed.) AJCC cancer staging manual, 6th edn. New York: Springer Verlag, 2002
12.
Zurück zum Zitat Liver cancer study group of Japan. Classification of primary liver cancer, 1st edn. Tokyo: Kanahara, 1997 Liver cancer study group of Japan. Classification of primary liver cancer, 1st edn. Tokyo: Kanahara, 1997
13.
Zurück zum Zitat Goodman ZD, Ishak KG, Langloss JM, et al. Combined hepatocellular-cholangiocarcinoma. A histologic and immunohistochemical study. Cancer 1985; 55:124–35PubMedCrossRef Goodman ZD, Ishak KG, Langloss JM, et al. Combined hepatocellular-cholangiocarcinoma. A histologic and immunohistochemical study. Cancer 1985; 55:124–35PubMedCrossRef
14.
Zurück zum Zitat Kojiro M. Patomorphology of advanced hepatocellular carcinoma. In: Tobe K, Kameda H, Okudaira M, et al. (eds) Primary liver cancer in Japan. Tokyo: Springer-Verlag 1992, pp 31–37 Kojiro M. Patomorphology of advanced hepatocellular carcinoma. In: Tobe K, Kameda H, Okudaira M, et al. (eds) Primary liver cancer in Japan. Tokyo: Springer-Verlag 1992, pp 31–37
15.
Zurück zum Zitat Nagafuchi Y, Okamoto K, Shono M, et al. Separate histogenesis of combined hepatocellular and cholangiocellular carcinoma in two patients. Hepatogastroenterology 1998; 45:523–7PubMed Nagafuchi Y, Okamoto K, Shono M, et al. Separate histogenesis of combined hepatocellular and cholangiocellular carcinoma in two patients. Hepatogastroenterology 1998; 45:523–7PubMed
16.
Zurück zum Zitat Liu CL, Fan ST, Lo CM, et al. Hepatic resection for combined hepatocellular and cholangiocarcinoma. Arch Surg 2003; 138:86–90PubMedCrossRef Liu CL, Fan ST, Lo CM, et al. Hepatic resection for combined hepatocellular and cholangiocarcinoma. Arch Surg 2003; 138:86–90PubMedCrossRef
17.
Zurück zum Zitat Koh KC, Lee H, Choi MS, et al. Clinicopathological features and prognosis of combined hepatocellular cholangiocarcinoma. Am J Surg 2005; 189:120–5PubMedCrossRef Koh KC, Lee H, Choi MS, et al. Clinicopathological features and prognosis of combined hepatocellular cholangiocarcinoma. Am J Surg 2005; 189:120–5PubMedCrossRef
18.
Zurück zum Zitat Yano Y, Yamamoto J, Kosuge T, et al. Combined hepatocellular and cholangiocarcinoma: a clinicopathologic study of 26 resected cases. Jpn J Clin Oncol 2003; 33:283–7PubMedCrossRef Yano Y, Yamamoto J, Kosuge T, et al. Combined hepatocellular and cholangiocarcinoma: a clinicopathologic study of 26 resected cases. Jpn J Clin Oncol 2003; 33:283–7PubMedCrossRef
19.
Zurück zum Zitat Portolani N, Coniglio A, Ghidoni S, et al. Early and late recurrence after liver resection for hepatocellular carcinoma (HCC). Prognostic and therapeutic implications. Ann Surg 2006; 243:229–35PubMedCrossRef Portolani N, Coniglio A, Ghidoni S, et al. Early and late recurrence after liver resection for hepatocellular carcinoma (HCC). Prognostic and therapeutic implications. Ann Surg 2006; 243:229–35PubMedCrossRef
20.
Zurück zum Zitat Chiesa R, Donato F, Portolani N, et al. Primary liver cancer in a high incidence area in north Italy: ethiological hypotheses arising from routinely collected data. Eur J Epidem 1995; 6:435–42CrossRef Chiesa R, Donato F, Portolani N, et al. Primary liver cancer in a high incidence area in north Italy: ethiological hypotheses arising from routinely collected data. Eur J Epidem 1995; 6:435–42CrossRef
21.
Zurück zum Zitat Donato F, Tagger A, Gelatti U, et al. Alcohol and hepatocellular carcinoma : the effect of lifetime intake and hepatitis virus infections in men and women. Am J Epidemiol 2002; 155:323–31PubMedCrossRef Donato F, Tagger A, Gelatti U, et al. Alcohol and hepatocellular carcinoma : the effect of lifetime intake and hepatitis virus infections in men and women. Am J Epidemiol 2002; 155:323–31PubMedCrossRef
22.
Zurück zum Zitat Kobayashi M, Ikeda K, Saitoh S, et al. Incidence of primary cholangiocellular carcinoma of the liver in Japanese patients with hepatitis C virus-related cirrhosis. Cancer 2000; 88:2471–7PubMedCrossRef Kobayashi M, Ikeda K, Saitoh S, et al. Incidence of primary cholangiocellular carcinoma of the liver in Japanese patients with hepatitis C virus-related cirrhosis. Cancer 2000; 88:2471–7PubMedCrossRef
23.
Zurück zum Zitat Han SL, Zhu GB, Yao JG, et al. Diagnosis and surgical treatment of primary hepatic cholangiocarcinoma. Hepatogastroenterology 2005; 52:348–51PubMed Han SL, Zhu GB, Yao JG, et al. Diagnosis and surgical treatment of primary hepatic cholangiocarcinoma. Hepatogastroenterology 2005; 52:348–51PubMed
24.
Zurück zum Zitat Shimoda M, Farmer DG, Colquhoun SD, et al. Liver transplantation for cholangiocellular carcinoma: analysis of single-center experience and review of the literature. Liver Transplantation 2001; 7:1023–33PubMedCrossRef Shimoda M, Farmer DG, Colquhoun SD, et al. Liver transplantation for cholangiocellular carcinoma: analysis of single-center experience and review of the literature. Liver Transplantation 2001; 7:1023–33PubMedCrossRef
25.
Zurück zum Zitat Valverde A, Bonhomme N, Farges O, et al. Resection of intrahepatic cholangiocarcinoma: a Western experience. J Hepatobiliary Pancreat Surg 1999; 6:122–7PubMedCrossRef Valverde A, Bonhomme N, Farges O, et al. Resection of intrahepatic cholangiocarcinoma: a Western experience. J Hepatobiliary Pancreat Surg 1999; 6:122–7PubMedCrossRef
26.
Zurück zum Zitat Kaczynski J, Hansson G, Wallersted S. Incidence, etiologic aspects and clinicophatologic features in intrahepatic cholangiocellular carcinoma: a study of 51 cases from a low-endemicity area. Acta Oncol 1998; 37:77–83PubMedCrossRef Kaczynski J, Hansson G, Wallersted S. Incidence, etiologic aspects and clinicophatologic features in intrahepatic cholangiocellular carcinoma: a study of 51 cases from a low-endemicity area. Acta Oncol 1998; 37:77–83PubMedCrossRef
27.
Zurück zum Zitat Roayaie S, Guarrera J, Ye MQ, et al. Aggressive surgical treatment of intrahepatic cholangiocarcinoma: predictors of outcomes. J Am Coll Surg 1998; 187:365–72PubMedCrossRef Roayaie S, Guarrera J, Ye MQ, et al. Aggressive surgical treatment of intrahepatic cholangiocarcinoma: predictors of outcomes. J Am Coll Surg 1998; 187:365–72PubMedCrossRef
28.
Zurück zum Zitat Sasaki A, Aramaki M, Kawano K, et al. Intrahepatic peripheral cholangiocarcinoma: mode of spread and choice of surgical treatment. Br J Surg 1998; 85:1206–9PubMedCrossRef Sasaki A, Aramaki M, Kawano K, et al. Intrahepatic peripheral cholangiocarcinoma: mode of spread and choice of surgical treatment. Br J Surg 1998; 85:1206–9PubMedCrossRef
29.
Zurück zum Zitat Nakeeb A, Pitt HA, Sohn TA, et al. Cholangiocarcinoma. A spectrum of intrahepatic, perihilar, and distal tumors. Ann Surg 1996; 224:463–75PubMedCrossRef Nakeeb A, Pitt HA, Sohn TA, et al. Cholangiocarcinoma. A spectrum of intrahepatic, perihilar, and distal tumors. Ann Surg 1996; 224:463–75PubMedCrossRef
30.
Zurück zum Zitat Nozaki Y, Yamamoto M, Ikai I, et al. Reconsideration of the lymph node metastasis pattern (N factor) from intrahepatic cholangiocarcinoma using the international union against cancer TNM staging system for primary liver carcinoma. Cancer 2001; 83:1923–9CrossRef Nozaki Y, Yamamoto M, Ikai I, et al. Reconsideration of the lymph node metastasis pattern (N factor) from intrahepatic cholangiocarcinoma using the international union against cancer TNM staging system for primary liver carcinoma. Cancer 2001; 83:1923–9CrossRef
31.
Zurück zum Zitat Isa T, Kusano T, Shimoji H, et al. Predictive factors for long-term survival in patients with intrahepatic cholangiocarcinoma. Am J Surg 2001; 181:507–11PubMedCrossRef Isa T, Kusano T, Shimoji H, et al. Predictive factors for long-term survival in patients with intrahepatic cholangiocarcinoma. Am J Surg 2001; 181:507–11PubMedCrossRef
32.
Zurück zum Zitat Inoue M, Makuuchi T, Takayama, et al. Long-term survival and prognostic factors in the surgical treatment of mass-forming type cholangiocarcinoma. Surgery 2000; 127:498–505PubMedCrossRef Inoue M, Makuuchi T, Takayama, et al. Long-term survival and prognostic factors in the surgical treatment of mass-forming type cholangiocarcinoma. Surgery 2000; 127:498–505PubMedCrossRef
33.
Zurück zum Zitat Grobmyer SR, Wang L, Gonen M, et al. Perihepatic lymph node assessment in patients undergoing partial hepatectomy for malignancy. Ann Surg 2006; 244:260–4PubMedCrossRef Grobmyer SR, Wang L, Gonen M, et al. Perihepatic lymph node assessment in patients undergoing partial hepatectomy for malignancy. Ann Surg 2006; 244:260–4PubMedCrossRef
34.
Zurück zum Zitat Akatsu T, Shimazu M, Kawachi S, et al. Long-term survival of intrahepatic cholangiocarcinoma with hilar lymph node metastasis and portal vein involvement. Hepatogastroenterology 2005; 52:603–5PubMed Akatsu T, Shimazu M, Kawachi S, et al. Long-term survival of intrahepatic cholangiocarcinoma with hilar lymph node metastasis and portal vein involvement. Hepatogastroenterology 2005; 52:603–5PubMed
35.
Zurück zum Zitat Lang H, Sotiropulos GC, Fruhauf NR, et al. Extended hepatectomy for intrahepatic cholangiocellular carcinoma (ICC). Ann Surg 2005; 241:134–43PubMed Lang H, Sotiropulos GC, Fruhauf NR, et al. Extended hepatectomy for intrahepatic cholangiocellular carcinoma (ICC). Ann Surg 2005; 241:134–43PubMed
36.
Zurück zum Zitat Puhalla H, Schuell B, Pokorny H, et al. Treatment and outcome of intrahepatic cholangiocellular carcinoma. Am J Surg 2005; 189:173–7PubMedCrossRef Puhalla H, Schuell B, Pokorny H, et al. Treatment and outcome of intrahepatic cholangiocellular carcinoma. Am J Surg 2005; 189:173–7PubMedCrossRef
37.
Zurück zum Zitat Slakey DP. Radiofequency ablation of recurrent cholangiocarcinoma. Am Surg 2002; 68:395–7PubMed Slakey DP. Radiofequency ablation of recurrent cholangiocarcinoma. Am Surg 2002; 68:395–7PubMed
38.
Zurück zum Zitat Shirabe K, Shimada M, Tsujita E. Prognostic factors in node-negative intrahepatic cholangiocarcinoma with special reference to angiogenesis. Am J Surg 2004; 187:538–42PubMedCrossRef Shirabe K, Shimada M, Tsujita E. Prognostic factors in node-negative intrahepatic cholangiocarcinoma with special reference to angiogenesis. Am J Surg 2004; 187:538–42PubMedCrossRef
Metadaten
Titel
Intrahepatic Cholangiocarcinoma and Combined Hepatocellular-Cholangiocarcinoma: A Western Experience
verfasst von
Nazario Portolani, MD
Gian Luca Baiocchi, MD
Arianna Coniglio, MD
Tullio Piardi, MD
Luigi Grazioli, MD
Anna Benetti, MD
Andrea Ferrari Bravo, MD
Stefano Maria Giulini, MD
Publikationsdatum
01.07.2008
Verlag
Springer-Verlag
Erschienen in
Annals of Surgical Oncology / Ausgabe 7/2008
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-008-9933-y

Weitere Artikel der Ausgabe 7/2008

Annals of Surgical Oncology 7/2008 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

CME: 2 Punkte

Prof. Dr. med. Gregor Antoniadis Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

CME: 2 Punkte

Dr. med. Benjamin Meyknecht, PD Dr. med. Oliver Pieske Das Webinar S2e-Leitlinie „Distale Radiusfraktur“ beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

CME: 2 Punkte

Dr. med. Mihailo Andric
Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.