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Clinicopathological prognostic factors after hepatectomy for patients with mass-forming type intrahepatic cholangiocarcinoma: relevance of the lymphatic invasion index.
Ann Surg Oncol. 2010 Jul; 17(7):1816-22.AS

Abstract

BACKGROUND

The present study was conducted to clarify the pathological factors in patients who underwent surgery for mass-forming type intrahepatic cholangiocarcinoma (IHC).

METHODS

From 1982 to July 2004, a total of 60 liver resections for mass-forming type IHC were performed at Kyushu University and its affiliated institutions. Portal venous, lymphatic, hepatic venous, and serosal invasion was examined by univariate and multivariate analyses for their prognostic value. The portal venous (PV) invasion index was defined as follows: PV0, portal venous invasion (-) and intrahepatic metastasis (-); PV1, portal venous invasion (+) or intrahepatic metastasis (+); PV2, portal venous invasion (+) and intrahepatic metastasis (+). The lymphatic invasion (LI) index was defined as follows: LI0, lymphatic duct invasion (-) and lymph node metastasis (-); LI1, intrahepatic lymphatic duct invasion (+) or lymph node metastasis (+); LI2, intrahepatic lymphatic duct invasion (+) and lymph node metastasis (+).

RESULTS

In univariate analysis, statistically significant prognostic factors for poor outcome were tumor size (>5 cm), serosal invasion (+), PV1 or PV2, LI1 or LI2, histological grade (moderate and poor), hepatic venous invasion (+) and noncurative resection. After multivariate analysis, the lymphatic invasion index and histological grade were statistically independent prognostic factors for overall survival and recurrence-free survival.

CONCLUSIONS

In patients with mass-forming type IHC, lymphatic invasion is the most important invasion pathway, compared with serosal and portal and hepatic venous invasion. Stratification of the lymphatic invasion pathway by lymphatic invasion, including intrahepatic lymphatic duct invasion and lymph node metastasis, is a good predictor for prognosis in patients after hepatectomy for mass-forming type IHC.

Authors+Show Affiliations

Department of Surgery and Sciences, Kyushu University, Fukuoka, Japan. kshirabe@surg2.med.kyushu-u.ac.jpNo affiliation info availableNo affiliation info availableNo 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

20135355

Citation

Shirabe, Ken, et al. "Clinicopathological Prognostic Factors After Hepatectomy for Patients With Mass-forming Type Intrahepatic Cholangiocarcinoma: Relevance of the Lymphatic Invasion Index." Annals of Surgical Oncology, vol. 17, no. 7, 2010, pp. 1816-22.
Shirabe K, Mano Y, Taketomi A, et al. Clinicopathological prognostic factors after hepatectomy for patients with mass-forming type intrahepatic cholangiocarcinoma: relevance of the lymphatic invasion index. Ann Surg Oncol. 2010;17(7):1816-22.
Shirabe, K., Mano, Y., Taketomi, A., Soejima, Y., Uchiyama, H., Aishima, S., Kayashima, H., Ninomiya, M., & Maehara, Y. (2010). Clinicopathological prognostic factors after hepatectomy for patients with mass-forming type intrahepatic cholangiocarcinoma: relevance of the lymphatic invasion index. Annals of Surgical Oncology, 17(7), 1816-22. https://doi.org/10.1245/s10434-010-0929-z
Shirabe K, et al. Clinicopathological Prognostic Factors After Hepatectomy for Patients With Mass-forming Type Intrahepatic Cholangiocarcinoma: Relevance of the Lymphatic Invasion Index. Ann Surg Oncol. 2010;17(7):1816-22. PubMed PMID: 20135355.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinicopathological prognostic factors after hepatectomy for patients with mass-forming type intrahepatic cholangiocarcinoma: relevance of the lymphatic invasion index. AU - Shirabe,Ken, AU - Mano,Yohei, AU - Taketomi,Akinobu, AU - Soejima,Yuji, AU - Uchiyama,Hideaki, AU - Aishima,Shinichi, AU - Kayashima,Hiroto, AU - Ninomiya,Mizuki, AU - Maehara,Yoshihiko, Y1 - 2010/02/05/ PY - 2009/10/27/received PY - 2010/2/6/entrez PY - 2010/2/6/pubmed PY - 2010/9/30/medline SP - 1816 EP - 22 JF - Annals of surgical oncology JO - Ann Surg Oncol VL - 17 IS - 7 N2 - BACKGROUND: The present study was conducted to clarify the pathological factors in patients who underwent surgery for mass-forming type intrahepatic cholangiocarcinoma (IHC). METHODS: From 1982 to July 2004, a total of 60 liver resections for mass-forming type IHC were performed at Kyushu University and its affiliated institutions. Portal venous, lymphatic, hepatic venous, and serosal invasion was examined by univariate and multivariate analyses for their prognostic value. The portal venous (PV) invasion index was defined as follows: PV0, portal venous invasion (-) and intrahepatic metastasis (-); PV1, portal venous invasion (+) or intrahepatic metastasis (+); PV2, portal venous invasion (+) and intrahepatic metastasis (+). The lymphatic invasion (LI) index was defined as follows: LI0, lymphatic duct invasion (-) and lymph node metastasis (-); LI1, intrahepatic lymphatic duct invasion (+) or lymph node metastasis (+); LI2, intrahepatic lymphatic duct invasion (+) and lymph node metastasis (+). RESULTS: In univariate analysis, statistically significant prognostic factors for poor outcome were tumor size (>5 cm), serosal invasion (+), PV1 or PV2, LI1 or LI2, histological grade (moderate and poor), hepatic venous invasion (+) and noncurative resection. After multivariate analysis, the lymphatic invasion index and histological grade were statistically independent prognostic factors for overall survival and recurrence-free survival. CONCLUSIONS: In patients with mass-forming type IHC, lymphatic invasion is the most important invasion pathway, compared with serosal and portal and hepatic venous invasion. Stratification of the lymphatic invasion pathway by lymphatic invasion, including intrahepatic lymphatic duct invasion and lymph node metastasis, is a good predictor for prognosis in patients after hepatectomy for mass-forming type IHC. SN - 1534-4681 UR - https://www.unboundmedicine.com/medline/citation/20135355/Clinicopathological_prognostic_factors_after_hepatectomy_for_patients_with_mass_forming_type_intrahepatic_cholangiocarcinoma:_relevance_of_the_lymphatic_invasion_index_ L2 - https://dx.doi.org/10.1245/s10434-010-0929-z DB - PRIME DP - Unbound Medicine ER -