Cystic Duct Carcinoma: A New Classification System and the Clinicopathological Features of 62 Patients

Abstract

BackgroundCystic duct carcinoma (CDC) is a rare biliary malignancy with a low incidence and poor prognosis. However, the clinical landscape of the disease has not been clarified and no widely applicable classification system has been developed.MethodsSixty-two patients with CDC were included in this retrospective study, and a new classification system was established using imaging data. Blood indices, radiological characteristics, pathological features, surgical procedures, and overall survival data were collected. The efficacy of the new classification in predicting resectability was evaluated using receiver operating characteristic (ROC) curves, and K-means clustering and t-distributed stochastic neighbor embedding were applied to verify the conclusion.ResultsThe pT stage of patients with type II CDC was significantly worse than that of type I. Patients with type II CDC were more likely to experience distant metastasis and invasion of the nervous system, vascular system, and liver. The resectability of patients with type II CDC was significantly worse than that of patients with type I CDC. Patients with type II CDC had worse prognoses. ROC curve analysis and K-means clustering revealed that the new classification could better categorize patients with CDC than currently available systems.ConclusionPatients with type II CDC have significantly worse clinicopathological outcomes. The new classification system has better accuracy in grouping patients with CDC.

Challenges in diagnosing and managing cystic duct carcinoma: A case report from Syria

“…In either diagnostic approach, it is imperative that residual cystic duct carcinoma is discerned occurring at least 5 years post-cholecystectomy for precise definition [ 8 ]. In our specific case, the tumor exhibited characteristics in line with Type 1 in Kim's classification, CC type in Yokohama's classification, and Type I in Nakata's classification [ 9 ].…”

Case and Management Considerations of Low-Grade Cystic Duct Stump Dysplasia after Laparoscopic Cholecystectomy

“…Farrar's [ 4 ] criteria published in 1951 defined CDC as a malignancy that was strictly limited to the cystic duct without any other biliary involvement. Since then, many types of classifications have been published including Ozden et al [ 5 ], Kim et al [ 6 ], Yokoyama et al [ 7 ], Nakata et al [ 8 ], and, most recently, Nan et al [ 9 ]. More recent classifications of CDC strive to better differentiate subtypes that invade adjacent structures such as the gallbladder, bile ducts, and more porta hepatis, since CDC often present in advanced stages [ 9 , 10 ].…”

A Preoperative Diagnosis of Advanced Cystic Duct Carcinoma Using SpyGlass DS Cholangioscopy: A Report of Two Cases

“…Ohtani et al also defined the primary site of a tumor as its geometric center ( 6 ), located along the longitudinal diameter of the tumor grossly. Several new classification systems of cystic duct carcinoma have been proposed based on this concept ( 4 , 7 - 9 ), and the tumor is treated as primary cystic duct carcinoma in the broad sense, even if it invades other organs, as long as its primary site of occupancy is clearly within the cystic duct. In our cases, the diagnosis of advanced cystic duct carcinoma was made because the center of the tumor was located in the cystic duct.…”