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Aggressive surgical resection for hilar-invasive and peripheral intrahepatic cholangiocarcinoma.
World J Surg. 2003 Mar; 27(3):289-93.WJ

Abstract

The clinicopathology and surgical outcome of intrahepatic cholangiocarcinomas are not fully understood. The objective of this study was to clarify the clinicopathologic features of intrahepatic cholangiocarcinoma and evaluate prognostic factors influencing survival. Forty consecutive patients with intrahepatic cholangiocarcinomas undergoing surgical resection at Chiba University Hospital between October 1981 and October 1997 were analyzed retrospectively. Intrahepatic cholangiocarcinomas were classified as hilar-invasive type (n = 26) or peripheral type (n = 14). Patients with peripheral-type tumors had a significantly (p = 0.005) better 5-year survival rate (43%) than those with the hilar-invasive type (4%). Hilar-invasive-type tumors had perineural invasion (100%) and nodal involvement (85%) more frequently than did peripheral-type tumors. Despite aggressive surgical resection, the surgical margin was positive in 88% of patients with hilar-invasive type tumors (23/26) and 29% of patients with peripheral-type tumors (4/14). There was no evidence of a survival benefit of vascular resection for patients with a hilar-invasive intrahepatic cholangiocarcinoma. Patients with lymph node metastasis had a significantly worse prognosis (p = 0.0004). No patients with nodal involvement survived more than 38 months. Negative perineural invasion (p = 0.008) and a negative microscopic margin (p = 0.008) were significantly associated with improved survival. Better survival results could be achieved by curative resection with a free margin for hilar-invasive and peripheral intrahepatic cholangiocarcinoma.

Authors+Show Affiliations

Second Department of Surgery, Chiba University School of Medicine, 1-8-1 Inohana, 260-8670, Chuo-ku, Chiba, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12607053

Citation

Nakagohri, Toshio, et al. "Aggressive Surgical Resection for Hilar-invasive and Peripheral Intrahepatic Cholangiocarcinoma." World Journal of Surgery, vol. 27, no. 3, 2003, pp. 289-93.
Nakagohri T, Asano T, Kinoshita H, et al. Aggressive surgical resection for hilar-invasive and peripheral intrahepatic cholangiocarcinoma. World J Surg. 2003;27(3):289-93.
Nakagohri, T., Asano, T., Kinoshita, H., Kenmochi, T., Urashima, T., Miura, F., & Ochiai, T. (2003). Aggressive surgical resection for hilar-invasive and peripheral intrahepatic cholangiocarcinoma. World Journal of Surgery, 27(3), 289-93.
Nakagohri T, et al. Aggressive Surgical Resection for Hilar-invasive and Peripheral Intrahepatic Cholangiocarcinoma. World J Surg. 2003;27(3):289-93. PubMed PMID: 12607053.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Aggressive surgical resection for hilar-invasive and peripheral intrahepatic cholangiocarcinoma. AU - Nakagohri,Toshio, AU - Asano,Takehide, AU - Kinoshita,Hirotoshi, AU - Kenmochi,Takashi, AU - Urashima,Tetsuro, AU - Miura,Fumihiko, AU - Ochiai,Takenori, Y1 - 2003/02/27/ PY - 2003/2/28/pubmed PY - 2003/7/2/medline PY - 2003/2/28/entrez SP - 289 EP - 93 JF - World journal of surgery JO - World J Surg VL - 27 IS - 3 N2 - The clinicopathology and surgical outcome of intrahepatic cholangiocarcinomas are not fully understood. The objective of this study was to clarify the clinicopathologic features of intrahepatic cholangiocarcinoma and evaluate prognostic factors influencing survival. Forty consecutive patients with intrahepatic cholangiocarcinomas undergoing surgical resection at Chiba University Hospital between October 1981 and October 1997 were analyzed retrospectively. Intrahepatic cholangiocarcinomas were classified as hilar-invasive type (n = 26) or peripheral type (n = 14). Patients with peripheral-type tumors had a significantly (p = 0.005) better 5-year survival rate (43%) than those with the hilar-invasive type (4%). Hilar-invasive-type tumors had perineural invasion (100%) and nodal involvement (85%) more frequently than did peripheral-type tumors. Despite aggressive surgical resection, the surgical margin was positive in 88% of patients with hilar-invasive type tumors (23/26) and 29% of patients with peripheral-type tumors (4/14). There was no evidence of a survival benefit of vascular resection for patients with a hilar-invasive intrahepatic cholangiocarcinoma. Patients with lymph node metastasis had a significantly worse prognosis (p = 0.0004). No patients with nodal involvement survived more than 38 months. Negative perineural invasion (p = 0.008) and a negative microscopic margin (p = 0.008) were significantly associated with improved survival. Better survival results could be achieved by curative resection with a free margin for hilar-invasive and peripheral intrahepatic cholangiocarcinoma. SN - 0364-2313 UR - https://www.unboundmedicine.com/medline/citation/12607053/Aggressive_surgical_resection_for_hilar_invasive_and_peripheral_intrahepatic_cholangiocarcinoma_ L2 - https://dx.doi.org/10.1007/s00268-002-6696-7 DB - PRIME DP - Unbound Medicine ER -