Intrahepatic Cholangiocarcinoma

Ercolani, Giorgio; Vetrone, Gaetano; Grazi, Gian Luca; Aramaki, Osamu; Cescon, Matteo; Ravaioli, Matteo; Serra, Carla; Brandi, Giovanni; Pinna, Antonio Daniele

doi:10.1097/sla.0b013e3181e462e6

Cited by 146 publications

(47 citation statements)

References 55 publications

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“…The treatment allocation for recurrent ICC is recognized as a significant factor in this study. Radical treatments after recurrence, such as re-resection and ablation, exhibited longterm PRS compared to non-radical treatment for ICC (13.6 vs. 5.3 months), which was consistent with the previous study (19). The capability of radical treatments for recurrent ICC in offering a better chance to eradicate micrometastases generated from the tumor may explain to it (19,30).…”

Section: Discussionsupporting

confidence: 89%

“…The choice of treatment for recurrence was determined from the characteristics of the recurrent tumor, patient preference, and discussion among our multidisciplinary team (MDT) (19)(20)(21). Treatment with curative intent, including surgical re-resection and ablation, was performed in patients with solitary intrahepatic recurrence without a portal vein tumor thrombus, and in patients with an extrahepatic recurrence for which curative treatment was feasible (20)(21)(22).…”

Section: Treatment Of Recurrencementioning

confidence: 99%

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A Novel Prognostic Nomogram for Patients With Recurrence of Intrahepatic Cholangiocarcinoma After Initial Surgery

Xing

Huang

et al. 2020

Front. Oncol.

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Background: The prognosis of patients with post-operative recurrent intrahepatic cholangiocarcinoma (ICC) is at great variance. We aimed to propose a novel efficient prognostic nomogram in facilitating the risk stratification for post-operative recurrent ICC patients.Methods: From 2000 to 2016, a total of 237 post-operative recurrent ICC patients were enrolled in this study, and randomly divided into training (n = 178) and validation cohorts (n = 59) at a ratio of 3:1. The performance of this nomogram was assessed by discrimination, calibration, and clinical usefulness, and the results were compared with four other currently used ICC staging systems.Results: On multivariate analysis of the training cohort, serum CA 19-9, albumin-bilirubin grade at recurrence, time from primary resection to recurrence, tumor number at recurrence, and treatment for recurrence were selected for the model. The concordance index (C-index) of our model was 0.791 [95% confidence interval (CI), 0.736-0.846], which was statistically higher than the values of the following systems: American Joint Committee on Cancer (AJCC) 8th edition (0.610), Liver Cancer Study Group of Japan (0.613), Nathan (0.582), and Okabayashi (0.600; P < 0.001 for all). The nomogram performed well in terms of calibration when compared with actual observation. The findings were supported by the validation cohort.Conclusions: Compared with four currently used staging systems for ICC, our nomogram showed more promising clinical utility in improving individualized predictions of survival for post-operative recurrent ICC patients.

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Section: Discussionsupporting

confidence: 89%

Section: Treatment Of Recurrencementioning

confidence: 99%

A Novel Prognostic Nomogram for Patients With Recurrence of Intrahepatic Cholangiocarcinoma After Initial Surgery

Xing

Huang

et al. 2020

Front. Oncol.

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“…Considerable interest has been paid to various treatment options against ICC recurrence such as surgical treatment,6, 7, 8 chemotherapy,9 radiation therapy,7 radiofrequency ablation (RFA),10, 11 and transarterial chemotherapy 12, 13 with various degrees of success. In recent reports, aggressive surgical treatment for ICC recurrence led to good patient survival after recurrence, with a 3‐year overall survival (OS) rate of 25%,14 40%,6 and 100% 7.…”

Section: Introductionmentioning

confidence: 99%

Surgical management of recurrent intrahepatic cholangiocarcinoma: predictors, adjuvant chemotherapy, and surgical therapy for recurrence: A multi‐institutional study by the Kyushu Study Group of Liver Surgery

Yamashita

Shirabe²,

Beppu³

et al. 2017

Annals of Gastroent Surgery

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Objectives of the present study were to identify predictors of the recurrence of intrahepatic cholangiocarcinoma (ICC), and to evaluate the survival benefit of adjuvant chemotherapy and surgical treatment for ICC recurrence. A multi‐institutional retrospective study was carried out in 356 patients with ICC who underwent curative surgery at one of 14 institutions belonging to the Kyushu Study Group of Liver Surgery. A total of 214 patients (60%) had recurrence. Predictors of ICC recurrence were as follows: positive for pathological intrahepatic metastasis (im), positive for lymph node metastasis (n), positive for pathological lymphatic infiltration (ly), pathological bile duct invasion (b), and tumor size ≥4.4 cm. Adjuvant chemotherapy was given to 120 patients (34%) and, in the patients with im or tumor size ≥4.4 cm, adjuvant chemotherapy showed a survival benefit. Only 37 patients (17%) underwent surgical treatment for ICC recurrence. The surgical treatment resulted in a good 5‐year survival rate (44%), which is similar to the rate obtained by the first operation for primary ICC. Prognosis of patients with primary im after the second operation was significantly worse (5‐year survival 18%) compared to patients without primary im. Primary im+ should be considered a contraindication for surgical treatment for ICC recurrence.

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“…The importance of N status has also been reported in previous studies. 7,10,11,[37][38][39][40][41][42][43][44] In a recent meta-analysis, LN metastasis was associated with increased risk of death in pool data (HR 2.09), 7 and Kim et al confirmed these findings reporting a similar relative risk of death associated with LN metastasis (HR 2.42; p < 0.001). 12 In the current study, lymph node metastasis (OR 4.64; p = 0.002) was one of the strongest independent predictors of poor prognosis and decreased chance of long-term survival.…”

Section: Discussionmentioning

confidence: 93%

Defining Long-Term Survivors Following Resection of Intrahepatic Cholangiocarcinoma

Bagante

Spolverato

Weiss

et al. 2017

Journal of Gastrointestinal Surgery

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Intrahepatic Cholangiocarcinoma

Abstract: Although recurrence rate represents a frequent problem in ICC, an aggressive approach to recurrence can significantly prolong survival.

Cited by 146 publications

References 55 publications

A Novel Prognostic Nomogram for Patients With Recurrence of Intrahepatic Cholangiocarcinoma After Initial Surgery

A Novel Prognostic Nomogram for Patients With Recurrence of Intrahepatic Cholangiocarcinoma After Initial Surgery

Surgical management of recurrent intrahepatic cholangiocarcinoma: predictors, adjuvant chemotherapy, and surgical therapy for recurrence: A multi‐institutional study by the Kyushu Study Group of Liver Surgery

Defining Long-Term Survivors Following Resection of Intrahepatic Cholangiocarcinoma

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