Preoperative evaluation with T-staging system for hilar cholangiocarcinoma

Chen, Rufu; Li, Zhihua; Zhou, Jue-Yu; Wang, Jie; Chen, Jisheng; Lin, Qingfen; Tang, Qi-Bing; Peng, Ning-Fu; Jiang, Zhipeng; Zhou, Qiujie

doi:10.3748/wjg.v13.i43.5754

Cited by 11 publications

(3 citation statements)

References 25 publications

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“…Firstly of note, the current systems (the Bismuth–Corlette and the AJCC/UICC) are not satisfactory, because they fail to consider all of the relevant local, tumor‐related variables that determine respectability, and they correlate poorly with survival. The Memorial Sloan–Kettering Cancer Center (MSKCC) devised a staging system for HCCA that encompasses a full radiological diagnosis and shows a correlation with increasing T stage and survival 3 67 . Secondly, in the current TNM staging system used for extrahepatic CCA, only a N0 and a N1 classification exist.…”

Section: Discussionmentioning

confidence: 99%

Surgery for extrahepatic cholangiocarcinoma: predictors of survival

Kloek

Kate

Busch

et al. 2008

HPB

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The incidence of extrahepatic cholangiocarcinoma is increasing worldwide and is often in an advanced stage at diagnosis and difficult to treat. The TNM (tumor node metastasis) cancer staging system predicts survival on the basis of tumor histopathology and the presence of distant metastases. However, numerous prognostic factors have been described that are not included in the TNM system. This review focuses on the prognostic significance of clinical, surgical, and histopathological factors as reported in the literature. Overall, the most important independent prognostic factors for long-term survival are negative surgical margins, lymph node status, and differentiation grade of the tumor. Further improvement of staging systems and identification of prognostic factors are crucial if we are to better select patients for surgical and adjuvant therapy and, hence, increase the rate of curative resections.

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Section: Discussionmentioning

confidence: 99%

Surgery for extrahepatic cholangiocarcinoma: predictors of survival

Kloek

Kate

Busch

et al. 2008

HPB

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“…This system is used to stratify preoperatively patients in regards to the likelihood of resectability and can be used to counsel patients on the potential for a R0 resection. The Memorial Sloan–Kettering Cancer Center staging system for perihilar CCA has since been externally validated [60]. …”

Section: Classification and Staging Of Perihilar Cholangiocarcinomamentioning

confidence: 99%

Management of perihilar cholangiocarcinoma in the era of multimodal therapy

Valero

Cosgrove

Herman

et al. 2012

Expert Review of Gastroenterology & Hepatology

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Perihilar cholangiocarcinoma (CCA) is the second most common primary malignant tumor of the liver. In the USA, there are approximately 3000 cases of CCA diagnosed annually, with approximately 50–70% of these tumors arising at the hilar plate of the biliary tree. Risk factors include advanced age, male gender, primary sclerosing cholangitis, choledochal cysts, cholelithiasis, parasitic infection, inflammatory bowel disease, cirrhosis and chronic pancreatitis. Patients typically present with jaundice, abdominal pain, pruritus and weight loss. The mainstays of treatment include surgery, chemotherapy, radiation therapy and photodynamic therapy. Specific preoperative interventions for patients with perihilar CCA include endoscopic retrograde cholangiopancreatography, percutanteous transhepatic cholangiography and portal vein embolization. Surgical resection offers the only chance for curative therapy in perihilar CCA. R0 resection is of utmost importance and has been linked to improved survival. Major hepatic resection is needed to achieve both longitudinal and radial margins negative for tumor. Fractionated stereotactic body radiotherapy has shown promising results in CCA. Perihilar CCA typically presents with advanced disease, and many patients receive systemic therapy; however, the response to current regimens is limited. Orthotopic liver transplantation offers complete resection of locally advanced tumors in select patient groups.

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“…[ 7 ] For example, patients with ICCA in the T1 stage had an R0 rate of 81.7%, while the R0 rate was 74.4% for patients with ECCA in the T1 stage. [ 39 , 40 ] Moreover, we also found that the rate of metastasis for ICCA in the T1 stage was lower than that for ECCA (Figs. 1 and 3 ).…”

Section: Discussionmentioning

confidence: 62%

Analysis of metastasis and survival between extrahepatic and intrahepatic cholangiocarcinoma

et al. 2021

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To date, extrahepatic cholangiocarcinoma (ECCA) and intrahepatic cholangiocarcinoma (ICCA) have rarely been compared; therefore, we attempted to learn more about the rates of metastasis and survival in both ICCA and ECCA. Data of patients in the SEER database diagnosed with ICCA or ECCA were extracted to analyse the rate of metastasis and survival. Univariate and multivariate logistic regression analyses were performed to identify the risk factors for metastasis. Propensity score matching (PSM) was used to compare survival rates between ECCA and ICCA. Data from a total of 15,751 patients diagnosed with ICCA or ECCA were extracted to analyse the rate of metastasis. Metastasis was more common in ECCA than ICCA (42.62% vs. 31.46%, P < .05), while ICCA in the T1 stage had a lower rate of metastasis (25.35% vs. 30.61%, P < .05). Age, pathology grade, tumour size, lymph node metastasis and T stage were independent risk factors for metastasis in both ECCA and ICCA. There was an inverse correlation between age and metastasis in both ICCA and ECCA. Moreover, PSM demonstrated that patients with ECCA had a better prognosis than patients with ICCA. Patients with ICCA in the T1 stage had better survival than those with ECCA in the T1 stage. Our study was the first to compare the rates of metastasis and survival between ECCA and ICCA. We observed an inverse association between age and metastasis, that patients with ECCA had a better prognosis than patients with ICCA, and that patients with ECCA in the T1 stage had worse survival than patients with ICCA in the T1 stage.

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Preoperative evaluation with T-staging system for hilar cholangiocarcinoma

Cited by 11 publications

References 25 publications

Surgery for extrahepatic cholangiocarcinoma: predictors of survival

Surgery for extrahepatic cholangiocarcinoma: predictors of survival

Management of perihilar cholangiocarcinoma in the era of multimodal therapy

Analysis of metastasis and survival between extrahepatic and intrahepatic cholangiocarcinoma

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