Skip to main content
Erschienen in: World Journal of Surgery 10/2007

01.10.2007

Surgical Outcomes of the Mass-Forming plus Periductal Infiltrating Types of Intrahepatic Cholangiocarcinoma: A Comparative Study with the Typical Mass-Forming Type of Intrahepatic Cholangiocarcinoma

verfasst von: Kazuaki Shimada, Tsuyoshi Sano, Yoshihiro Sakamoto, Minoru Esaki, Tomoo Kosuge, Hidenori Ojima

Erschienen in: World Journal of Surgery | Ausgabe 10/2007

Einloggen, um Zugang zu erhalten

Abstract

Background

The purpose of this study was to clarify the clinicopathologic characteristics and surgical outcomes of patients with the mass-forming (MF) plus periductal infiltrating (PI) type of intrahepatic cholangiocellular carcinoma (ICC).

Methods

Between January 1, 1998, and December 31, 2004, a total of 94 patients with ICC underwent macroscopic curative resection, and the macroscopic type of the tumors was assessed prospectively. Among the 74 patients with the MF type (n = 46) and the MF plus PI type (n = 28) of ICC, multivariate analysis was conducted to identify the potential prognostic factors. The clinicopathologic data of the two groups were compared.

Results

The results revealed two independent prognostic factors: presence/absence of intrahepatic metastasis and the macroscopic type of the tumor. ICCs categorized macroscopically as the MF plus PI type were significantly associated with jaundice (p < 0.001), bile duct invasion (p < 0.001), portal vein invasion (p = 0.025), lymph node involvement (p = 0.017), and positive surgical margin (p = 0.038).

Conclusion

Identification of the macroscopic type of the tumor is useful for predicting survival after hepatectomy in patients with ICC. The MF plus PI type of ICC appears to have a more unfavorable prognosis, even after radical surgery, than the MF type of ICC.
Literatur
1.
Zurück zum Zitat Liver Cancer Study group of Japan (1990) Primary liver cancer in Japan: clinicopathologic features and results of surgical treatment. Ann Surg 211:277–287 Liver Cancer Study group of Japan (1990) Primary liver cancer in Japan: clinicopathologic features and results of surgical treatment. Ann Surg 211:277–287
2.
Zurück zum Zitat Craig JR, Peters RL, Edmondson HA (1989) Tumors of the liver and intrahepatic bile duct. In: Hartmann WH, editor. Atlas of tumor pathology. 2nd Series. Fascicle 26. Armed Forces Institute of Pathology, Washington, DC Craig JR, Peters RL, Edmondson HA (1989) Tumors of the liver and intrahepatic bile duct. In: Hartmann WH, editor. Atlas of tumor pathology. 2nd Series. Fascicle 26. Armed Forces Institute of Pathology, Washington, DC
3.
Zurück zum Zitat Patel T (2001) Increasing incidence and mortality of primary intrahepatic cholangiocarcinoma in the United States. Hepatology 33:1353–1357PubMedCrossRef Patel T (2001) Increasing incidence and mortality of primary intrahepatic cholangiocarcinoma in the United States. Hepatology 33:1353–1357PubMedCrossRef
4.
Zurück zum Zitat Liver Cancer Study Group of Japan (1997) Classification of primary liver cancer. 1st edn. Kanehara, Tokyo, pp 6–7 Liver Cancer Study Group of Japan (1997) Classification of primary liver cancer. 1st edn. Kanehara, Tokyo, pp 6–7
5.
Zurück zum Zitat Nakajima T, Kondo Y, Miyazaki M, et al. (1988) A histopathologic study of 102 cases of intrahepatic cholangiocarcinoma: histologic classification and modes of spreading. Hum Pathol 19:1228–1234PubMedCrossRef Nakajima T, Kondo Y, Miyazaki M, et al. (1988) A histopathologic study of 102 cases of intrahepatic cholangiocarcinoma: histologic classification and modes of spreading. Hum Pathol 19:1228–1234PubMedCrossRef
6.
Zurück zum Zitat Yamamoto J, Kosuge T, Takayama T, et al. (1992) Surgical treatment of intrahepatic cholangiocarcinoma: four patients surviving more than five years. Surgery 111:617–622PubMed Yamamoto J, Kosuge T, Takayama T, et al. (1992) Surgical treatment of intrahepatic cholangiocarcinoma: four patients surviving more than five years. Surgery 111:617–622PubMed
7.
Zurück zum Zitat Sasaki A, Aramaki M, Kawano K, et al. (1998) Intrahepatic peripheral cholangiocarcinoma: mode of spread and choice of surgical treatment. Br J Surg 85:1206–1209PubMedCrossRef Sasaki A, Aramaki M, Kawano K, et al. (1998) Intrahepatic peripheral cholangiocarcinoma: mode of spread and choice of surgical treatment. Br J Surg 85:1206–1209PubMedCrossRef
8.
Zurück zum Zitat Sano T, Kamiya J, Nagino M, et al. (1999) Macroscopic classification and preoperative diagnosis of intrahepatic cholangiocarcinoma in Japan. J Hepatobiliary Pancreat Surg 6:101–107PubMedCrossRef Sano T, Kamiya J, Nagino M, et al. (1999) Macroscopic classification and preoperative diagnosis of intrahepatic cholangiocarcinoma in Japan. J Hepatobiliary Pancreat Surg 6:101–107PubMedCrossRef
9.
Zurück zum Zitat Yamanaka N, Okamoto E, Ando T, et al. (1995) Clinocopathologic spectrum of resected extraductal mass-forming intrahepatic cholangiocarcinoma. Cancer 76:2449–2456PubMedCrossRef Yamanaka N, Okamoto E, Ando T, et al. (1995) Clinocopathologic spectrum of resected extraductal mass-forming intrahepatic cholangiocarcinoma. Cancer 76:2449–2456PubMedCrossRef
10.
Zurück zum Zitat Yamamoto M, Takasaki K, Yoshikawa T, et al. (1988) Does gross appearance indicate prognosis in intrahepatic cholangiocarcinoma? J Surg Oncol 69:162–167CrossRef Yamamoto M, Takasaki K, Yoshikawa T, et al. (1988) Does gross appearance indicate prognosis in intrahepatic cholangiocarcinoma? J Surg Oncol 69:162–167CrossRef
11.
Zurück zum Zitat Ohtsuka M, Ito F, Kimura H, et al. (2002) Results of surgical treatment for intrahepatic cholangiocarcinoma and clinicopathological factors influencing survival. Br J Surg 89:1525–1531PubMedCrossRef Ohtsuka M, Ito F, Kimura H, et al. (2002) Results of surgical treatment for intrahepatic cholangiocarcinoma and clinicopathological factors influencing survival. Br J Surg 89:1525–1531PubMedCrossRef
12.
Zurück zum Zitat Yamasaki S (2003) Intrahepatic cholangiocarcinoma: macroscopic type and stage classification. J Hepatobiliary Pancreat Surg 10:288–291PubMedCrossRef Yamasaki S (2003) Intrahepatic cholangiocarcinoma: macroscopic type and stage classification. J Hepatobiliary Pancreat Surg 10:288–291PubMedCrossRef
13.
Zurück zum Zitat Yeh CN, Jan YY, Yeh TS, et al (2004) Hepatic resection of the intraductal papillary type of peripheral cholangiocarcinoma. Ann Surg Oncol 11:606–611PubMedCrossRef Yeh CN, Jan YY, Yeh TS, et al (2004) Hepatic resection of the intraductal papillary type of peripheral cholangiocarcinoma. Ann Surg Oncol 11:606–611PubMedCrossRef
14.
Zurück zum Zitat Inoue K, Makuuchi M, Takayama K, et al. (2000) Long-term survival and prognostic factors in the surgical treatment of mass-forming type cholangiocarcinoma. Surgery 127:498–505PubMed Inoue K, Makuuchi M, Takayama K, et al. (2000) Long-term survival and prognostic factors in the surgical treatment of mass-forming type cholangiocarcinoma. Surgery 127:498–505PubMed
15.
Zurück zum Zitat Cherqui D, Tantawi B, Alon R, et al. (1995) Intrahepatic cholangiocarcinoma: results of aggressive surgical management. Arch Surg 130:1073–1078PubMed Cherqui D, Tantawi B, Alon R, et al. (1995) Intrahepatic cholangiocarcinoma: results of aggressive surgical management. Arch Surg 130:1073–1078PubMed
16.
Zurück zum Zitat Lang H, Sotiropoulos GC, Frühauf NR, et al. (2005) Extended hepatectomy for intrahepatic cholangiocellular carcinoma (ICC)—when is it worthwhile? Single center experience with 27 resctions in 50 patients over 5-year period. Ann Surg 241:134–143PubMed Lang H, Sotiropoulos GC, Frühauf NR, et al. (2005) Extended hepatectomy for intrahepatic cholangiocellular carcinoma (ICC)—when is it worthwhile? Single center experience with 27 resctions in 50 patients over 5-year period. Ann Surg 241:134–143PubMed
17.
Zurück zum Zitat Kamada T, Saitou H, Takamura A, et al. (1996) The role of radiotherapy in the management of extrahepatic bile duct cancer: an analysis of 145 consecutive patients treated with intramural and/or external beam radiotherapy. Int J Radiat Oncol Biol Phys 34:767–774PubMedCrossRef Kamada T, Saitou H, Takamura A, et al. (1996) The role of radiotherapy in the management of extrahepatic bile duct cancer: an analysis of 145 consecutive patients treated with intramural and/or external beam radiotherapy. Int J Radiat Oncol Biol Phys 34:767–774PubMedCrossRef
18.
Zurück zum Zitat Todoroki T, ohhara K, Kawamoto, et al. (2000) Benefits of radiotherapy after resection of locally advanced main hepatic duct carcinoma. Int J Radiat Oncol Biol Phys 46:69–127CrossRef Todoroki T, ohhara K, Kawamoto, et al. (2000) Benefits of radiotherapy after resection of locally advanced main hepatic duct carcinoma. Int J Radiat Oncol Biol Phys 46:69–127CrossRef
19.
Zurück zum Zitat Stein DE, Heron DE, Rosato EL, et al. (2005) Positive microscopic margins after outcome in lymph node-negative cholangiocarcinoma when resection is combined with adjuvant radiotherapy. Am J Clin Oncol 28:21–23PubMedCrossRef Stein DE, Heron DE, Rosato EL, et al. (2005) Positive microscopic margins after outcome in lymph node-negative cholangiocarcinoma when resection is combined with adjuvant radiotherapy. Am J Clin Oncol 28:21–23PubMedCrossRef
20.
Zurück zum Zitat Shimada M, Yamashita Y, Aishima S, et al. (2001) Value of lymph node dissection during resection of intrahepatic cholangiocarcinoma. Br J Surg 88:1463–1466PubMedCrossRef Shimada M, Yamashita Y, Aishima S, et al. (2001) Value of lymph node dissection during resection of intrahepatic cholangiocarcinoma. Br J Surg 88:1463–1466PubMedCrossRef
21.
Zurück zum Zitat Okabayashi T, Yamamoto J, Kosuge T, et al. (2001) A new staging system for mass-forming intrahepatic cholangiocarcinoma: analysis of preoperative and postoperative variables. Cancer 92:2374–2383PubMedCrossRef Okabayashi T, Yamamoto J, Kosuge T, et al. (2001) A new staging system for mass-forming intrahepatic cholangiocarcinoma: analysis of preoperative and postoperative variables. Cancer 92:2374–2383PubMedCrossRef
22.
Zurück zum Zitat Nakagawa T, Kamiyama T, Kurauchi N, et al. (2005) Number of lymph node metastases is a significant prognostic factor in intrahepatic cholangiocarcinoma. World J Surg 29:728–733PubMedCrossRef Nakagawa T, Kamiyama T, Kurauchi N, et al. (2005) Number of lymph node metastases is a significant prognostic factor in intrahepatic cholangiocarcinoma. World J Surg 29:728–733PubMedCrossRef
23.
Zurück zum Zitat Ercolani G, Grazi GL, Ravaioli M, et al. (2004) The role of lymphadenectomy for liver tumors: further consideration on the appropriateness of treatment strategy. Ann Surg 239:202–209PubMedCrossRef Ercolani G, Grazi GL, Ravaioli M, et al. (2004) The role of lymphadenectomy for liver tumors: further consideration on the appropriateness of treatment strategy. Ann Surg 239:202–209PubMedCrossRef
Metadaten
Titel
Surgical Outcomes of the Mass-Forming plus Periductal Infiltrating Types of Intrahepatic Cholangiocarcinoma: A Comparative Study with the Typical Mass-Forming Type of Intrahepatic Cholangiocarcinoma
verfasst von
Kazuaki Shimada
Tsuyoshi Sano
Yoshihiro Sakamoto
Minoru Esaki
Tomoo Kosuge
Hidenori Ojima
Publikationsdatum
01.10.2007
Verlag
Springer-Verlag
Erschienen in
World Journal of Surgery / Ausgabe 10/2007
Print ISSN: 0364-2313
Elektronische ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-007-9194-0

Weitere Artikel der Ausgabe 10/2007

World Journal of Surgery 10/2007 Zur Ausgabe

Letter to the Editor

Reply

Update Chirurgie

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

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

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“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar 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“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

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.