Long-term survival and prognostic factors in the surgical treatment for intrahepatic cholangiocarcinoma

Morimoto, Yoshikazu; Tanaka, Yasuhiro; Ito, Toshinori; Nakahara, Masaaki; Nakaba, Hiroyuki; Nishida, Toshiro; Fujikawa, Masahiro; Ito, Toshikazu; Yamamoto, Shungo; Kitagawa, Toru

doi:10.1007/s00534-002-0842-3

Cited by 125 publications

(141 citation statements)

References 20 publications

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“…In addition, our study confirmed previously reported prognostic factors in cholangiocarcinoma, such as macroscopic type, intrahepatic metastasis, lymph node metastasis, and histological classification (Yamamoto et al, 1998;Ohtsuka et al, 2002;Morimoto et al, 2003;DeOliveira et al, 2007). Expression of EGFR or HER2 is known to be a prognostic factor in some cancers (Gusterson et al, 1992;Nicholson et al, 2001), but no previous study has clarified the influence of these molecules on prognosis in cholangiocarcinoma (Ito et al, 2001;Altimari et al, 2003;Nakazawa et al, 2005), probably because cholangiocarcinoma is a relatively rare cancer and collection of a large cohort is difficult.…”

Section: Discussionsupporting

confidence: 80%

Clinicopathological and prognostic significance of EGFR, VEGF, and HER2 expression in cholangiocarcinoma

Yoshikawa

Ojima²,

Iwasaki³

et al. 2007

Br J Cancer

351

311

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Epidermal growth factor receptor (EGFR), vascular endothelial growth factor (VEGF), and human epidermal growth factor receptor 2 (HER2) have been considered as potential therapeutic targets in cholangiocarcinoma, but no studies have yet clarified the clinicopathological or prognostic significance of these molecules. Immunohistochemical expression of these molecules was assessed retrospectively in 236 cases of cholangiocarcinoma, as well as associations between the expression of these molecules and clinicopathological factors or clinical outcome. The proportions of positive cases for EGFR, VEGF, and HER2 overexpression were 27.4, 53.8, and 0.9% in intrahepatic cholangiocarcinoma (IHCC), and 19.2, 59.2, and 8.5% in extrahepatic cholangiocarcinoma (EHCC), respectively. Clinicopathologically, EGFR overexpression was associated with macroscopic type (P ¼ 0.0120), lymph node metastasis (P ¼ 0.0006), tumour stage (P ¼ 0.0424), lymphatic vessel invasion (P ¼ 0.0371), and perineural invasion (P ¼ 0.0459) in EHCC, and VEGF overexpression with intrahepatic metastasis (P ¼ 0.0224) in IHCC. Multivariate analysis showed that EGFR expression was a significant prognostic factor (hazard ratio (HR), 2.67; 95% confidence interval (CI), 1.52 -4.69; P ¼ 0.0006) and also a risk factor for tumour recurrence (HR, 1.89; 95% CI, 1.05 -3.39, P ¼ 0.0335) in IHCC. These results suggest that EGFR expression is associated with tumour progression and VEGF expression may be involved in haematogenic metastasis in cholangiocarcinoma.

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Section: Discussionsupporting

confidence: 80%

Clinicopathological and prognostic significance of EGFR, VEGF, and HER2 expression in cholangiocarcinoma

Yoshikawa

Ojima²,

Iwasaki³

et al. 2007

Br J Cancer

351

311

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“…When compared with the mass forming type, those with intraductal growth type had a 0.25 times (95% CI: 0.11-0.57) lower risk of death, and those with the periductal infiltrating type had a 0.63 times (95% CI: 0.29-1.34) lower risk of death. These findings are almost the same as those in the study reported by Morimoto et al (2003). However, Guglielmi et al (2009) reported a rather different finding; patients with mass forming cancers had longer survival rates.…”

Section: Discussionsupporting

confidence: 87%

Survival Rate of Intrahepatic Cholangiocarcinoma Patients after Surgical Treatment in Thailand

Sriputtha¹,

Khuntikeo²,

Promthet³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Intrahepatic cholangiocarcinoma (ICC), one of the primary liver cancers, is frequent in the northeastern part of Thailand. Surgical resection remains the best method of treatment, but patients suffering from ICC usually present at a late stage of the disease. Studies of survival and prognostic factors after surgery remain rare. The aim here was to evaluate the survival rate and factors affecting the survival of patients with intrahepatic cholangiocarcinoma after surgery. The study used a retrospective cohort design. The subjects were 73 consecutive patients with ICC, who were admitted for surgery to Srinagarind Hospital, Khon Kaen University, during the period 2005-2009. The censoring date was 31 December, 2011, data being evaluated using uni-and multivariate analyses. Postoperative survival analysis was performed by the Kaplan-Meier method, and the Cox proportional hazard model was used to identify independent prognostic factors. The total follow-up time was 99 person-years. The total number of deaths was 59, giving a mortality rate of 59 per 100 person-years. The cumulative 1-, 3-, and 5-year survival rates were 52.1%, 21.7%, and 11.2%, respectively. The median duration of survival after resection was 12.4 months. Univariate analysis revealed stage of disease, lymph node metastasis, histological type, histological grade and macroscopic classification to be statistically significant (p-value<0.05) prognostic factors. In the multivariate analysis, only macroscopic classification was statistically significant (p-value<0.05). In conclusion, macroscopic classification was the only independent factor found to be significantly associated with survival following surgical treatment of ICC.

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“…The poor prognosis is due to the anatomical position of the gallbladder and the delayed clinical presentation in most patients, primarily due to a lack of specific symptoms and low clinical suspicion. The only curative therapy for gallbladder carcinoma is surgical resection [3][4][5]. The goal of resection should always be total tumor extirpation with negative histologic margins.…”

Section: Introductionmentioning

confidence: 99%

Prognostic Significance of Volume-based Metabolic Parameters by 18F-FDG PET/CT in Gallbladder Carcinoma

Yoo

Choi

Lee

et al. 2012

Nucl Med Mol Imaging

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Purpose We investigated the prognostic values of volumebased metabolic parameters by 18 F-fluorodeoxyglucose ( 18 F-FDG) positron emission tomography (PET)/computed tomography (CT) in gallbladder carcinoma patients and compared them with other prognostic parameters. Materials and Methods We enrolled 44 patients, who were initially diagnosed with gallbladder carcinoma and undergoing 18 F-FDG PET/CT. Various metabolic volume-based PET parameters of primary tumors, including maximum and average standardized uptake values (SUV max , SUV avg ), metabolic tumor volume (MTV), and total lesion glycolysis (TLG), were measured in gallbladder carcinoma patients using mediastinal blood pool activity as a threshold SUV for determining the tumor boundaries. Overall survival analysis was performed using the Kaplan-Meier method with PET parameters and other clinical variables. For determining independent prognostic factors, Cox proportional hazards regression analysis was performed. ResultsOf the 44 enrolled patients, cancer-or treatmentrelated death occurred in 30 (68.2 %). The mean clinical follow-up period was 22.2±10.4 m (range, 0.6-35.9 m). Univariate analysis demonstrated that clinical or pathologic TNM stage (P < 0.001), treatment modality (P <0.001), MTV (cutoff 0 135 cm 3 , P00.001), and TLG (cutoff 0 7,090, P<0.05) were significant prognostic factors. In multivariate analysis, both clinical or pathologic TNM stage [hazard ratio (HR)02.019 (I vs II), 21.287 (I vs III), and 24.354 (I vs IV); P00.001) and TLG (HR02.930; P<0.05) were independent prognostic factors for predicting overall survival. Conclusions In gallbladder cancer, TLG of the primary tumor, a volume-based metabolic parameter, is a significant independent prognostic factor for overall survival in conjunction with the clinical or pathological TNM stage.

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Long-term survival and prognostic factors in the surgical treatment for intrahepatic cholangiocarcinoma

Abstract: Analysis of the clinicopathologic factors influencing the survival after surgical treatment showed that the macroscopic type, surgical curability, lymph node metastasis, tumor size, and cancer-free margin were the most predictive.

Cited by 125 publications

References 20 publications

Clinicopathological and prognostic significance of EGFR, VEGF, and HER2 expression in cholangiocarcinoma

Clinicopathological and prognostic significance of EGFR, VEGF, and HER2 expression in cholangiocarcinoma

Survival Rate of Intrahepatic Cholangiocarcinoma Patients after Surgical Treatment in Thailand

Prognostic Significance of Volume-based Metabolic Parameters by 18F-FDG PET/CT in Gallbladder Carcinoma

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