Survival Outcomes and Prognostic Factors of Surgical Therapy for All Potentially Resectable Intrahepatic Cholangiocarcinoma: a Large Single-Center Cohort Study

Luo, Xianwu; Liu, Yuan; Wang, Yi; Ge, Ruowen; Sun, Ying; Wei, Gongtian

doi:10.1007/s11605-013-2447-3

Cited by 96 publications

(81 citation statements)

References 47 publications

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“…In earlier studies on ICC, cirrhosis (21), unlike HBV infection (13,18,19), was shown to be an independent unfavorable prognostic factor for survival, but little is known on the underlying mechanism. However, the multivariate analysis in this series and our former study (20) revealed that cirrhosis was an independent favorable prognostic factor for survival of ICC patients following surgery. Different sample sizes may be the reason for the different results reported by these studies regarding the role of cirrhosis in ICC prognosis.…”

Section: Discussioncontrasting

confidence: 56%

“…Although HBV infection has been reported to be a favorable prognostic factor for ICC patients and the clinicopathological characteristics differ between patients with and those without HBV infection (13,18,19), the role of cirrhosis in the prognosis of ICC patients has not been fully elucidated due to the limited number of related studies. Cirrhosis has been found to be a favorable prognostic factor for ICC patients in our former study (20); however, the opposite result was reported by another previous study (21). The aim of the present study was to determine the effect of cirrhosis on the prognosis of ICC patients and the…”

Section: Introductionmentioning

confidence: 56%

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Comparison of clinicopathological characteristics between cirrhotic and non-cirrhotic patients with intrahepatic cholangiocarcinoma: A large-scale retrospective study

Liu

Luo

et al. 2017

Molecular and Clinical Oncology

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Abstract. The effect of cirrhosis on the characteristics of intrahepatic cholangiocarcinoma (ICC) has not been fully elucidated. The purpose of this study was to investigate how cirrhosis affects the clinicopathological characteristics and survival of surgically treated ICC patients. A total of 1,312 ICC patients surgically treated between January 2007 and December 2011 at a single institution were retrospectively reviewed and the clinicopathological data were compared between cirrhotic and non-cirrhotic patients. Univariate and multivariate analyses were performed to identify significant and independent prognostic factors in this cohort. A total of 302 patients (23.0%) were cirrhotic. Compared with cirrhotic patients, the tumors in non-cirrhotic patients were usually larger, less differentiated, and more likely to have lymphatic metastasis, vascular and perineural invasion. Following resection, cirrhotic patients achieved a longer survival compared with non-cirrhotic patients (16.0 vs. 13.0 months, respectively; P<0.038). Multivariate analysis demonstrated that hepatitis B virus infection and cirrhosis were independent favorable prognostic factors, while the presence of cholelithiasis, elevated carbohydrate antigen 19-9 and carcinoembryonic antigen levels, multiple tumors, lymphatic metastasis, vascular invasion and positive surgical margin status were independent unfavorable prognostic factors. Overall, the clinicopathological characteristics of ICC patients with and without cirrhosis differed significantly. Compared with cirrhotic patients, in whom the biological behavior of ICC was similar to that of HCC, non-cirrhotic patients exhibited higher-risk pathological characteristics, lower curative resection rate and worse survival.

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Section: Discussioncontrasting

confidence: 56%

Section: Introductionmentioning

confidence: 56%

Comparison of clinicopathological characteristics between cirrhotic and non-cirrhotic patients with intrahepatic cholangiocarcinoma: A large-scale retrospective study

Liu

Luo

et al. 2017

Molecular and Clinical Oncology

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“…However, in patients with cirrhosis, surgical results were controversial. Li et al reported that survival rates were poorer for patients with cirrhosis than for those without cirrhosis, whereas Luo et al reported that the median survival in months was longer for patients with cirrhosis than for those without cirrhosis [71,72]. Further evaluation of surgical outcomes is required because anatomical hepatectomy can be difficult in patients with cirrhosis.…”

Section: Surgical Results For Icc With Cirrhosis or Chronic Viral Hepmentioning

confidence: 99%

Intrahepatic cholangiocarcinoma and cholangiolocellular carcinoma in cirrhosis and chronic viral hepatitis

Ariizumi

Yamamoto

2014

Surg Today

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Intrahepatic cholangiocarcinoma (ICC) is the second most common primary liver cancer. Cirrhosis and chronic viral hepatitis are known to be important risk factors for ICC, especially the mass-forming (MF) type of ICC at the periphery of the liver. Cholangiolocellular carcinoma (CoCC) is a rare type of primary liver cancer, which is thought to originate from hepatic progenitor or stem cells. CoCC often exhibits the similar MF type at the periphery of the liver, as ICC, and CoCC is also associated with cirrhosis or chronic viral hepatitis. Better survival rates after surgery have been reported for ICC patients with chronic viral hepatitis than for those without chronic viral hepatitis, although survival rates did not differ significantly in relation to cirrhosis. On the other hand, patients with CoCC had better surgical results than those with MF-type ICC. This review summarizes the clinical characteristics and surgical outcomes of ICC and CoCC associated with cirrhosis or chronic viral hepatitis.

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“…However, Liu et al (23) observed that the presence of inflammation was associated with improved postoperative survival in ICC patients. Luo et al (24) concluded that preoperative chronic proliferative cholangitis, possibly caused by hepatolithiasis, was unrelated to the OS of ICC. In our study, the univariate analysis identified preoperative cholangitis as a disadvantageous factor associated with the OS of ECC patients, while the multivariate analysis with a Cox proportional hazards model did not yield similar results.…”

Section: Discussionmentioning

confidence: 99%

Survival outcomes and progonostic factors of extrahepatic cholangiocarcinoma patients following surgical resection: Adjuvant therapy is a favorable prognostic factor

Yang

Zhou²,

Wei

et al. 2014

Molecular and Clinical Oncology

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This study was conducted to investigate survival and prognostic factors for extrahepatic cholangiocarcinoma (ECC) following surgical resection and evaluate the effects of postoperative adjuvant therapy (AT) on overall survival (OS). We retrospectively collected clinical and pathological data between March, 2008 and December, 2013. The Kaplan-Meier method and the COX regression model were used to evaluate the OS and prognostic factors of 105 postoperative ECC patients, of whom 32 had received AT. The patients were stratified into seven risk subgroups and the survival rates were compared within each subgroup between patients who received AT and those who did not. The results demonstrated a median OS of 17.6 months, with 1- and 3-year survival rates of 67.9 and 19.5%, respectively, for the entire cohort. On univariate analysis, preoperative cholangitis, non-R0 surgical margins, poor differentiation grade, stage 3/4 and lymphatic metastasis were identified as adverse prognostic factors. AT was not significantly associated with improved OS. However, the subgroup analysis revealed that the effect of AT was significant only in the lymphatic metastasis group (median OS, 21.6 vs. 10.4 months; and 3-year OS, 16.6 vs. 0%, respectively; P=0.02). The survival curves of the AT and non-AT groups were significantly different only for node-positive patients. The COX regression model identified lymphatic metastasis, surgical margins and AT as independent prognostic factors for ECC. A negative resection margin may reduce the mortality rate following surgery by 47%. By contrast, lymph node metastasis was associated with a 2.18-fold higher mortality rate for ECC patients. Postoperative AT contributed to a 0.45-fold mortality rate compared to non-AT ECC patients. Therefore, we concluded that AT is a favorable prognostic factor for ECC patients and it may prolong the survival of patients with lymphatic metastasis. Our data suggest that postoperative AT should be recommended for node-positive ECC patients.

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Survival Outcomes and Prognostic Factors of Surgical Therapy for All Potentially Resectable Intrahepatic Cholangiocarcinoma: a Large Single-Center Cohort Study

Cited by 96 publications

References 47 publications

Comparison of clinicopathological characteristics between cirrhotic and non-cirrhotic patients with intrahepatic cholangiocarcinoma: A large-scale retrospective study

Comparison of clinicopathological characteristics between cirrhotic and non-cirrhotic patients with intrahepatic cholangiocarcinoma: A large-scale retrospective study

Intrahepatic cholangiocarcinoma and cholangiolocellular carcinoma in cirrhosis and chronic viral hepatitis

Survival outcomes and progonostic factors of extrahepatic cholangiocarcinoma patients following surgical resection: Adjuvant therapy is a favorable prognostic factor

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