Incidence and Prognosis of Subsequent Cholangiocarcinoma in Patients with Hepatic Resection for Bile Duct Stones

Kim, Hyun Jung; Kang, Tae Uk; Swan, Heather; Kang, Min Ji; Kim, Nayoung; Ahn, Hyeong Sik; Park, Seon Mee

doi:10.1007/s10620-018-5262-6

Cited by 18 publications

(12 citation statements)

References 41 publications

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“…In a retrospective study by Zhang et al [34], in line with our result, hepatitis was found to be with poor prognosis in IHCC, while in the study by Zhou et al, hepatitis was a favorable prognostic factor [35]. The prognositic value of age was controversial, most study reported that age had no prognostic value in cholangiocarcinoma [34, 36–38]. Mavros et al and Kato et al found that older age was associated with worse prognosis [39, 40].…”

Section: Discussionsupporting

confidence: 79%

Failure patterns after curative resection for intrahepatic cholangiocarcinoma: possible implications for postoperative radiotherapy

Shui

et al. 2019

BMC Cancer

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BackgroundTo explore the patterns of failures and areas at highest risk of recurrence for postoperative intrahepatic cholangiocarcinoma (IHCC), with the aim to guide IHCC adjuvant radiotherapy.MethodsPatients with IHCC who had undergone radical surgery at our institution from July 2010 to August 2017 were retrospectively analyzed. The survival and prognostic factors were analyzed by univariate and multivariate analysis. All sites of recurrence were found out and classified as the surgical margin, regional lymph nodes, liver remnant and distant metastasis. According to the recurring area at highest risk, the target volume of adjuvant radiotherapy was proposed.ResultsThe median follow-up time was 23.5 months (2–85 months). The median recurrence free survival (RFS) and overall survival (OS) were 12.1 months and 24.8 months, respectively. Seventy-three (73/127, 57.5%) IHCC patients developed tumor recurrence. Initial recurrences occurred in the potential postoperative radiotherapy (PORT) volume, remnant liver and distant sits were 46 (46/73, 63.0%), 36 (36/73, 49.3%) and 22 (22/73, 30.1%) cases, respectively. Of the 46 patients whose initial recurrence inside the potential PORT volume, 29 (29/73, 39.7%) developed recurrence only inside the potential PORT volume, including 13 tumor bed recurrences, 7 lymph node metastases, and 9 with both tumor bed recurrences and lymph node metastases. The most common lymph node metastases sites were nodes around the abdominal aorta, followed by lymph nodes along the celiac artery, the common hepatic artery, and in the hepatoduodenal ligament.ConclusionsHigh proportion of the recurrences occurred only inside the potential PORT volume, implying adjuvant radiotherapy might improve the local-regional control. Surgical margins and lymph node stations No.16a2, 9, 8, 12, 13, and 14 are suggested to be included in the radiation volume.

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Section: Discussionsupporting

confidence: 79%

Failure patterns after curative resection for intrahepatic cholangiocarcinoma: possible implications for postoperative radiotherapy

Shui

et al. 2019

BMC Cancer

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“…In the present study, sex was an independent prognostic factor in the univariate analysis ( P <0.001), and it was not statistically significant in the multivariate model ( P =0.79). Previous studies have shown that sex is an independent prognostic factor and that male patients have shorter survival times than female patients ( 22 , 23 ).…”

Section: Discussionmentioning

confidence: 99%

Establishment and validation of a prognostic nomogram for extrahepatic cholangiocarcinoma

Zhao

Yang

et al. 2022

Front. Oncol.

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Simple summaryAccurately estimate the prognosis of patients with ECCA is important. However, the TNM system has some limitations, such as low accuracy, exclusion of other factors (e.g., age and sex), and poor performance in predicting individual survival risk. In contrast, a nomogram-based clinical model related to a comprehensive analysis of all risk factors is intuitive and straightforward, facilitating the probabilistic analysis of tumor-related risk factors. Simultaneously, a nomogram can also effectively drive personalized medicine and facilitate clinicians for prognosis prediction. Therefore, we construct a novel practical nomogram and risk stratification system to predict CSS in patients with ECCA.BackgroundAccurately estimate the prognosis of patients with extrahepatic cholangiocarcinoma (ECCA) was important, but the existing staging system has limitations. The present study aimed to construct a novel practical nomogram and risk stratification system to predict cancer-specific survival (CSS) in ECCA patients.Methods3415 patients diagnosed with ECCA between 2010 and 2015 were selected from the SEER database and randomized into a training cohort and a validation cohort at 7:3. The nomogram was identified and calibrated using the C-index, receiver operating characteristic curve (ROC), and calibration plots. Decision curve analysis (DCA), net reclassification index (NRI), integrated discrimination improvement (IDI) and the risk stratification were used to compare the nomogram with the AJCC staging system.ResultsNine variables were selected to establish the nomogram. The C-index (training cohort:0.785; validation cohort:0.776) and time-dependent AUC (>0.7) showed satisfactory discrimination. The calibration plots also revealed that the nomogram was consistent with the actual observations. The NRI (training cohort: 1-, 2-, and 3-year CSS:0.27, 0.27,0.52; validation cohort:1-,2-,3-year CSS:0.48,0.13,0.34), IDI (training cohort: 1-, 2-, 3-year CSS:0.22,0.18,0.16; validation cohort: 1-,2-,3-year CSS:0.18,0.16,0.17), and DCA indicated that the established nomogram significantly outperformed the AJCC staging system (P<0.05) and had better recognition compared to the AJCC staging system.ConclusionsWe developed a practical prognostic nomogram to help clinicians assess the prognosis of patients with ECCA.

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“…In a retrospective study by Zhang et al [34] , in line with our result, hepatitis was found to be with poor prognosis in IHCC, while in the study by Zhou et al, hepatitis was a favorable prognostic factor [35] . The prognositic value of age was controversial, most study reported that age had no prognostic value in cholangiocarcinoma [34,[36][37][38] . Mavros et al and Kato et al found that older age was associated with worse prognosis [39,40] .…”

Section: Discussionmentioning

confidence: 99%

Failure patterns after curative resection for intrahepatic cholangiocarcinoma: Possible implications for postoperative radiotherapy

Shui

et al. 2019

Preprint

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Background: To document the patterns of failure，identify sites at highest risk of recurrence following curative resection of intrahepatic cholangiocarcinoma (IHCC), in order to guide adjuvant postoperative radiotherapy (PORT). Methods: Patients with IHCC who had undergone radical surgery at our institution from July 2010 to August 2017 were retrospectively analyzed. The survival and prognostic factors were evaluated using univariate and multivariate analysis. All sites of recurrence were recorded and classified including the surgical margin, regional lymph nodes, liver remnant and distant metastasis. The sites at highest risk of recurrence form the basis of the target volume of potential adjuvant radiotherapy. Results: The median follow-up time was 23.5 months (2-85 months). The median recurrence free survival (RFS) and overall survival (OS) were 12.1 months and 24.8 months, respectively. Seventy-three (73/127, 57.5%) IHCC patients developed tumor recurrence. The number of initial recurrences occurring in the potential PORT volume, remnant liver and distant sits were 46 (46/73, 63.0%), 36 (36/73, 49.3%) and 22 (22/73, 30.1%) cases, respectively. Of the 46 patients whose initial recurrence were inside the potential PORT volume, 29 (29/73, 39.7%) developed recurrence confined to the potential PORT volume, including 13 tumor bed recurrences, 7 lymph node metastases, and 9 with both tumor bed recurrences and lymph node metastases. The most common lymph node metastases were nodes around the abdominal aorta, followed by lymph nodes along the celiac artery, the common hepatic artery, and in the hepatoduodenal ligament. Conclusions: A high proportion of the recurrences occurred only within the potential PORT volume, implying that adjuvant radiotherapy might improve local-regional control. It seems reasonable to include surgical margins and lymph node stations No.16a2, 9, 8, 12, 13, and 14 in the radiation treatment volume.

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Incidence and Prognosis of Subsequent Cholangiocarcinoma in Patients with Hepatic Resection for Bile Duct Stones

Abstract: Subsequent CCA developed in 2% of the patients with hepatic resection for benign BDS until 10 years and was associated with poorer prognoses than concomitant CCA. Future studies focused on the long-term surveillance for CCA in such patients are needed.

Cited by 18 publications

References 41 publications

Failure patterns after curative resection for intrahepatic cholangiocarcinoma: possible implications for postoperative radiotherapy

Failure patterns after curative resection for intrahepatic cholangiocarcinoma: possible implications for postoperative radiotherapy

Establishment and validation of a prognostic nomogram for extrahepatic cholangiocarcinoma

Failure patterns after curative resection for intrahepatic cholangiocarcinoma: Possible implications for postoperative radiotherapy

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