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Indications for laparoscopic liver resection of mass-forming intrahepatic cholangiocarcinoma.
Asian J Endosc Surg. 2020 Jan; 13(1):46-58.AJ

Abstract

INTRODUCTION

We investigated the indications for laparoscopic liver resection (LLR) of mass-forming intrahepatic cholangiocarcinoma (MF-ICC), including the need for lymph node dissection for improved postoperative prognosis.

METHODS

This study involved 36 patients who underwent surgery for solitary peripheral MF-ICC. Fifteen patients underwent LLR, and 21 underwent open liver resection (OLR). Surgical outcomes and prognostic factors were investigated to determine the indications for LLR.

RESULTS

No significant differences were observed in perioperative outcomes between patients who underwent LLR and OLR. A significantly worse disease-free survival (DFS) rate was observed in patients who preoperatively had a tumor diameter ≥3 cm, vascular invasion on diagnostic imaging, and elevated serum carbohydrate antigen (CA) 19-9 and carcinoembryonic antigen (CEA) levels. A significantly worse overall survival (OS) rate was observed in patients with a tumor diameter ≥3 cm, vascular invasion on diagnostic imaging, and elevated serum CA19-9 levels. Therefore, a tumor diameter ≥3 cm, vascular invasion on diagnostic imaging, and elevated serum CA19-9 and CEA levels were determined to be preoperative prognostic factors. DFS and OS rates were significantly better in patients without these factors. Moreover, in six patients without these factors who underwent LLR, neither lymph node metastasis nor postoperative recurrence was observed.

CONCLUSION

A tumor diameter ≥3 cm, vascular invasion on diagnostic imaging, and elevated serum CA19-9 and CEA levels are preoperative prognostic factors for peripheral MF-ICC. LLR is indicated for patients without these factors.

Authors+Show Affiliations

Department of Hepato-Biliary-Pancreatic Surgery, Osaka City General Hospital, Osaka, Japan.Department of Hepato-Biliary-Pancreatic Surgery, Osaka City General Hospital, Osaka, Japan.Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.Department of Hepato-Biliary-Pancreatic Surgery, Osaka City General Hospital, Osaka, Japan.Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.Department of Hepato-Biliary-Pancreatic Surgery, Osaka City General Hospital, Osaka, Japan.Department of Hepato-Biliary-Pancreatic Surgery, Osaka City General Hospital, Osaka, Japan.Department of Hepato-Biliary-Pancreatic Surgery, Osaka City General Hospital, Osaka, Japan.Department of Hepato-Biliary-Pancreatic Surgery, Osaka City General Hospital, Osaka, Japan.Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.Department of Surgery, Osaka City Juso Hospital, Osaka, Japan.Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30924307

Citation

Kinoshita, Masahiko, et al. "Indications for Laparoscopic Liver Resection of Mass-forming Intrahepatic Cholangiocarcinoma." Asian Journal of Endoscopic Surgery, vol. 13, no. 1, 2020, pp. 46-58.
Kinoshita M, Kanazawa A, Takemura S, et al. Indications for laparoscopic liver resection of mass-forming intrahepatic cholangiocarcinoma. Asian J Endosc Surg. 2020;13(1):46-58.
Kinoshita, M., Kanazawa, A., Takemura, S., Tanaka, S., Kodai, S., Shinkawa, H., Shimizu, S., Murata, A., Nishio, K., Hamano, G., Ito, T., Tsukamoto, T., & Kubo, S. (2020). Indications for laparoscopic liver resection of mass-forming intrahepatic cholangiocarcinoma. Asian Journal of Endoscopic Surgery, 13(1), 46-58. https://doi.org/10.1111/ases.12703
Kinoshita M, et al. Indications for Laparoscopic Liver Resection of Mass-forming Intrahepatic Cholangiocarcinoma. Asian J Endosc Surg. 2020;13(1):46-58. PubMed PMID: 30924307.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Indications for laparoscopic liver resection of mass-forming intrahepatic cholangiocarcinoma. AU - Kinoshita,Masahiko, AU - Kanazawa,Akishige, AU - Takemura,Shigekazu, AU - Tanaka,Shogo, AU - Kodai,Shintaro, AU - Shinkawa,Hiroji, AU - Shimizu,Sadatoshi, AU - Murata,Akihiro, AU - Nishio,Kohei, AU - Hamano,Genya, AU - Ito,Tokuji, AU - Tsukamoto,Tadashi, AU - Kubo,Shoji, Y1 - 2019/03/28/ PY - 2018/12/12/received PY - 2019/02/22/revised PY - 2019/02/25/accepted PY - 2019/3/30/pubmed PY - 2020/10/6/medline PY - 2019/3/30/entrez KW - intrahepatic cholangiocarcinoma KW - laparoscopic liver resection KW - lymph nodes dissection SP - 46 EP - 58 JF - Asian journal of endoscopic surgery JO - Asian J Endosc Surg VL - 13 IS - 1 N2 - INTRODUCTION: We investigated the indications for laparoscopic liver resection (LLR) of mass-forming intrahepatic cholangiocarcinoma (MF-ICC), including the need for lymph node dissection for improved postoperative prognosis. METHODS: This study involved 36 patients who underwent surgery for solitary peripheral MF-ICC. Fifteen patients underwent LLR, and 21 underwent open liver resection (OLR). Surgical outcomes and prognostic factors were investigated to determine the indications for LLR. RESULTS: No significant differences were observed in perioperative outcomes between patients who underwent LLR and OLR. A significantly worse disease-free survival (DFS) rate was observed in patients who preoperatively had a tumor diameter ≥3 cm, vascular invasion on diagnostic imaging, and elevated serum carbohydrate antigen (CA) 19-9 and carcinoembryonic antigen (CEA) levels. A significantly worse overall survival (OS) rate was observed in patients with a tumor diameter ≥3 cm, vascular invasion on diagnostic imaging, and elevated serum CA19-9 levels. Therefore, a tumor diameter ≥3 cm, vascular invasion on diagnostic imaging, and elevated serum CA19-9 and CEA levels were determined to be preoperative prognostic factors. DFS and OS rates were significantly better in patients without these factors. Moreover, in six patients without these factors who underwent LLR, neither lymph node metastasis nor postoperative recurrence was observed. CONCLUSION: A tumor diameter ≥3 cm, vascular invasion on diagnostic imaging, and elevated serum CA19-9 and CEA levels are preoperative prognostic factors for peripheral MF-ICC. LLR is indicated for patients without these factors. SN - 1758-5910 UR - https://www.unboundmedicine.com/medline/citation/30924307/Indications_for_laparoscopic_liver_resection_of_mass_forming_intrahepatic_cholangiocarcinoma_ L2 - https://doi.org/10.1111/ases.12703 DB - PRIME DP - Unbound Medicine ER -