Impact of microvascular invasion on clinical outcomes after curative‐intent resection for intrahepatic cholangiocarcinoma

Hu, Liang Shuo; Weiss, Matthew J.; Popescu, Irinel; Marques, Hugo P.; Aldrighetti, Luca; Maithel, Shishir K.; Pulitano, Carlo; Bauer, Todd W.; Shen, Feng; Poultsides, George A.; Soubrane, O.; Martel, Guillaume; Koerkamp, Bas Groot; Endo, Itaru; Pawlik, Timothy M.

doi:10.1002/jso.25305

Cited by 45 publications

(25 citation statements)

References 41 publications

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“…The results yielded by UICC stratification were marginally better, with a C-index of 0.61. When stratified according to the UICC stages, patients in UICC stages II and III in particular showed overlap of survival curves, supporting the predictive value of intrahepatic vascular invasion and intrahepatic metastasis [8,21]. However, concordance indices in the vicinity of 0.6 must be considered as only moderate, which applies to both the MEGNA score and the UICC system [16].…”

Section: Discussionmentioning

confidence: 90%

Risk prediction in intrahepatic cholangiocarcinoma: Direct comparison of the MEGNA score and the 8th edition of the UICC/AJCC Cancer staging system

et al. 2020

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Section: Discussionmentioning

confidence: 90%

Risk prediction in intrahepatic cholangiocarcinoma: Direct comparison of the MEGNA score and the 8th edition of the UICC/AJCC Cancer staging system

et al. 2020

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“…Scholars have not yet come to a consensus regarding the prognostic factors of cHCC-CCA. Although previous studies have confirmed that microvascular invasion (MVI) is a prognostic factor for tumor recurrence and is associated with poor survival outcomes in HCC [ 11 – 14 ] and ICC [ 15 , 16 ], the relationship between prognosis and the presence of MVI in cHCC-CCA patients has not yet been established.…”

Section: Introductionmentioning

confidence: 99%

Combined hepatocellular-cholangiocarcinoma: which preoperative clinical data and conventional MRI characteristics have value for the prediction of microvascular invasion and clinical significance?

Wang

et al. 2020

Eur Radiol

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Objectives To explore which preoperative clinical data and conventional MRI findings may indicate microvascular invasion (MVI) of combined hepatocellular-cholangiocarcinoma (cHCC-CCA) and have clinical significance. Methods The study enrolled 113 patients with histopathologically confirmed cHCC-CCA (MVI-positive group [n = 56], MVI-negative group [n = 57]). Two radiologists retrospectively assessed the preoperative MRI features (qualitative analysis of morphology and dynamic enhancement features), and each lesion was assigned according to the LI-RADS. Preoperative clinical data were also evaluated. Logistic regression analyses were used to assess the relative value of these parameters as potential predictors of MVI. Recurrence-free survival (RFS) rates after hepatectomy in the two groups were estimated using Kaplan–Meier survival curves and compared using the log-rank test. Results The majority of cHCC-CCAs were categorized as LR-M. On multivariate analysis, a higher serum AFP level (OR, 0.523; 95% CI, 0.282–0.971; p = 0.040), intratumoral fat deposition (OR, 14.368; 95% CI, 2.749–75.098; p = 0.002), and irregular arterial peritumoral enhancement (OR, 0.322; 95% CI, 0.164–0.631; p = 0.001) were independent variables associated with the MVI of cHCC-CCA. After hepatectomy, patients with MVI of cHCC-CCA showed earlier recurrence than those without MVI (hazard ratio [HR], 0.402; 95% CI, 0.189–0.854, p = 0.013). Conclusion A higher serum AFP level and irregular arterial peritumoral enhancement are potential predictive biomarkers for the MVI of cHCC-CCA, while intratumoral fat detected on MRI suggests a low risk of MVI. Furthermore, cHCC-CCAs with MVI may have worse surgical outcomes with regard to early recurrence than those without MVI. Key Points • Higher serum levels of AFP combined with irregular arterial peritumoral enhancement are independent risk factors for the MVI of cHCC-CCA, while fat deposition might be a protective factor. • cHCC-CCA with MVI may have a higher risk of early recurrence after surgery. • Most cHCC-CCAs were categorized as LR-M in this study, and no significant difference was found in MVI based on LI-RADS category.

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“…As a result of late diagnosis, ICC frequently presents with large and/or multiple tumors [2,3]. Currently, the major treatment modalities consist of surgical resection, regional therapy, chemotherapy, and liver transplantation [4], but the long-term prognosis of ICC remains disappointing because of the high recurrence rate [5].…”

Section: Introductionmentioning

confidence: 99%

Impact of liver fibrosis score on prognosis after common therapies for intrahepatic cholangiocarcinoma: a propensity score matching analysis

Zhang

Chen

et al. 2020

BMC Cancer

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Background: Liver fibrosis or cirrhosis is associated with the dismal prognosis of hepatocellular carcinoma (HCC), and it might also be involved in intrahepatic cholangiocarcinoma (ICC). The effect of hepatic fibrosis on the survival of ICC patients is still unclear. This study aims to explore whether liver fibrosis impacts the overall survival (OS) and disease-specific survival (DSS) of ICC patients. Methods: Data of 729 eligible ICC patients receiving different therapies from the Surveillance, Epidemiology, and End Results database (2004-2015) were analyzed. Unmatched, propensity score-matched, and propensity scoreweighted cohorts were used to investigate the relationships of different fibrosis scores (low fibrosis score vs. high fibrosis score) and survival. A Cox regression and Kaplan-Meier curves were used to explore the influence of fibrosis score on patients' survival. Stratified analyses based on treatment modality were conducted to compare the survival difference in ICC patients with different fibrosis scores. Results: Before matching, the one-, three-, and five-year OS were 50.9, 28.0, and 16.1% in the low fibrosis score group (n = 465) and 39.3, 20.1, and 8.0% in the high fibrosis score group (n = 264) (P < 0.001), respectively. After propensity score matching, the one-, three-, and five-year OS were 45.0, 26.0, and 10.2% in the low fibrosis score group and 36.0, 8.1, and 2.3% in the high fibrosis score group (P = 0.008), respectively. The multivariate Cox regression results showed that a high fibrosis score was an independent risk factor of OS. Additionally, patients with high fibrosis scores achieved low DSS after matching (P = 0.032). The survival benefits of the low fibrosis score group were consistent across treatment cohorts. Conclusions: High fibrosis scores were associated with poor clinical outcomes of ICC patients receiving different common therapies.

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Impact of microvascular invasion on clinical outcomes after curative‐intent resection for intrahepatic cholangiocarcinoma

Cited by 45 publications

References 41 publications

Risk prediction in intrahepatic cholangiocarcinoma: Direct comparison of the MEGNA score and the 8th edition of the UICC/AJCC Cancer staging system

Risk prediction in intrahepatic cholangiocarcinoma: Direct comparison of the MEGNA score and the 8th edition of the UICC/AJCC Cancer staging system

Combined hepatocellular-cholangiocarcinoma: which preoperative clinical data and conventional MRI characteristics have value for the prediction of microvascular invasion and clinical significance?

Impact of liver fibrosis score on prognosis after common therapies for intrahepatic cholangiocarcinoma: a propensity score matching analysis

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