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01.10.2007 | Ausgabe 10/2007

World Journal of Surgery 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

Zeitschrift:
World Journal of Surgery > Ausgabe 10/2007
Autoren:
Kazuaki Shimada, Tsuyoshi Sano, Yoshihiro Sakamoto, Minoru Esaki, Tomoo Kosuge, Hidenori Ojima

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.

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