Defining the possible therapeutic benefit of lymphadenectomy among patients undergoing hepatic resection for intrahepatic cholangiocarcinoma

Vitale, Alessandro; Moustafa, Mohamed; Spolverato, Gaya; Gani, Faiz; Cillo, Umberto; Pawlik, Timothy M.

doi:10.1002/jso.24213

Cited by 56 publications

(46 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As noted previously, the status of the nodal basin is an important prognostic factor among patients with ICC. In addition to tumour characteristics such as tumour size, lesion number and vascular invasion, LNM has consistently been identified as one of the strongest prognostic factors associated with long‐term outcomes of patients with ICC 5–9,12–14,29 .…”

Section: Discussionmentioning

confidence: 86%

Trends in use of lymphadenectomy in surgery with curative intent for intrahepatic cholangiocarcinoma

Zhang

Chakedis

Bagante

et al. 2018

British Journal of Surgery

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 86%

Trends in use of lymphadenectomy in surgery with curative intent for intrahepatic cholangiocarcinoma

Zhang

Chakedis

Bagante

et al. 2018

British Journal of Surgery

View full text Add to dashboard Cite

show abstract

“…Specifically, patients with mixed HCC‐ICC who had lymph node metastasis had a marked increased risk of death. While not performed for patients with HCC, routine lymphadenectomy has been strongly advocated for patients with ICC . Our group, in particular, has noted that lymphadenectomy for ICC tumors provides better prognostic information, may reduce local nodal recurrence, and can help direct adjuvant therapy decisions .…”

Section: Discussionmentioning

confidence: 99%

“…While not performed for patients with HCC, routine lymphadenectomy has been strongly advocated for patients with ICC . Our group, in particular, has noted that lymphadenectomy for ICC tumors provides better prognostic information, may reduce local nodal recurrence, and can help direct adjuvant therapy decisions . To this point, the recently published BILCAP trial compared 6 months of adjuvant capecitabine to observation following surgical resection of biliary tract cancer and noted improved OS among patients who had received chemotherapy .…”

Section: Discussionmentioning

confidence: 99%

Management and outcomes among patients with mixed hepatocholangiocellular carcinoma: A population‐based analysis

Spolverato

Bagante

Tsilimigras

et al. 2018

Journal of Surgical Oncology

Self Cite

View full text Add to dashboard Cite

Background We sought to define the management of mixed hepatocellular carcinoma‐intrahepatic cholangiocarcinoma (HCC‐ICC) as well as characterize short‐ and long‐term outcomes of patients with mixed HCC‐ICC. Methods Patients diagnosed with HCC‐ICC, HCC, or ICC between 2004 and 2015 were identified from the National Cancer Data Base using the International Classification of Diseases for Oncology codes. Short‐ and long‐term outcomes were assessed using univariate and multivariate analyses. Results Among 174 454 patients, 86.8% had HCC, 12.1% ICC, and 1.1% HCC‐ICC. The incidence of lymphadenectomy was 55.6% among ICC patients vs 15.1% and 34.2% for HCC and HCC‐ICC patients, respectively (P < 0.001). A 90‐day mortality was comparable among patients with HCC (9.1%), ICC (8.8%), and HCC‐ICC (10.5%) (all P > 0.2). While 42.0% of ICC patients received adjuvant chemotherapy, adjuvant chemotherapy among HCC and HCC‐ICC patients was 13.1% and 27.4%, respectively (P < 0.001). A 5‐year survival was 43.5% (95% CI, 42.5‐44.5), 33.3% (95% CI, 31.4‐35.3), 34.4% (95% CI, 29.1‐39.8) for HCC, ICC, and HCC‐ICC patients, respectively. Conclusion Patients who underwent resection of mixed HCC‐ICC had a prognosis that was comparable to ICC, yet worse than HCC. Utilization of lymphadenectomy and adjuvant therapy were low. HCC‐ICC remains a rare disease with a guarded prognosis that should be treated in a multidisciplinary setting.

show abstract

“…Although positive lymph nodes are a significant prognostic factor, aggressive lymphadenectomy is being controversially discussed. The opponents argue that the high biliary morbidity due to ischemic bile duct injuries may offset the potential oncological benefit, and thus some centers limit the indication to only centrally localized tumors [23]. …”

Section: Intrahepatic Cholangiocarcinomamentioning

confidence: 99%

“…Periductal tumor growth along the periportal fields resulting in extensive infiltration of surrounding tissue seems to be one of the explanations for the unsatisfactory outcome [23]. …”

Section: Intrahepatic Cholangiocarcinomamentioning

confidence: 99%

Surgical Therapy of Cholangiocarcinoma

Radtke

Königsrainer

2016

Visc Med

View full text Add to dashboard Cite

Background: The majority of patients with cholangiocarcinoma present with advanced disease that is often challenging to diagnose and to treat. The optimal preoperative evaluation requires a coordinated multidisciplinary approach. Surgical resection is the mainstay of therapy. Methods: This systematic review delineates surgical treatment strategies for cholangiocarcinoma in general as well as special considerations concerning the particular tumor localization. A literature search (see keywords) was conducted using PubMed and publications between 1990 and 2016 regarding resectable and advanced cholangiocarcinoma were reviewed. Selected studies were utilized based on their significance and innovation. Results: The type and extent of resection performed depends on the location of the cholangiocarcinoma within the liver or biliary tree and the extent of local tumor invasion. The common surgical strategy contains: (i) for intrahepatic tumors: tailored partial hepatectomy combined with extended hilar, suprapancreatic, celiac axis lymphadenectomy, (ii) for hilar tumors: complete resection of the extrahepatic biliary tree combined with extended hepatectomy inclusive of segment I, resection of portal vein bifurcation, and systematic N1/N2 lymphadenectomy, and (iii) for distal tumors: en bloc pancreatoduodenectomy combined with complete resection of the extrahepatic bile duct below the hepatic confluence and systematic N1/N2 lymphadenectomy. Pathologic confirmation is not required prior to resection. Preoperative biliary drainage and remnant liver volume augmentation are necessary in selected patients with intrahepatic or hilar cholangiocarcinoma considered for extensive liver resection. Conclusion: Cure for cholangiocarcinoma requires complete surgical resection with histologically negative margins. R0 resection provides a satisfactory long-term outcome in patients with lymph node-negative stage. Neoadjuvant treatment followed by liver transplantation provides long-term survival in highly selected cases with localized, unresectable, lymph node-negative hilar cholangiocarcinoma.

show abstract

Defining the possible therapeutic benefit of lymphadenectomy among patients undergoing hepatic resection for intrahepatic cholangiocarcinoma

Abstract: LND therapeutic benefit among a subset of patients. Future work is required to investigate the role of routine LND among these patients. J. Surg. Oncol. 2016;113:685-691. © 2016 Wiley Periodicals, Inc.

Cited by 56 publications

References 48 publications

Trends in use of lymphadenectomy in surgery with curative intent for intrahepatic cholangiocarcinoma

Trends in use of lymphadenectomy in surgery with curative intent for intrahepatic cholangiocarcinoma

Management and outcomes among patients with mixed hepatocholangiocellular carcinoma: A population‐based analysis

Surgical Therapy of Cholangiocarcinoma

Contact Info

Product

Resources

About