What is the impact of coexistence of hepatolithiasis on cholangiocarcinoma?

Lee, Cheng‐Chi; Wu, Chun Ying; Chen, Gran Hum

doi:10.1046/j.1440-1746.2002.02779.x

Cited by 39 publications

(27 citation statements)

References 19 publications

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“…In our study, women were associated with hepatolithiasis and men were associated with clonorchiasis, which is consistent with previous reports [25,26]. We speculate that men are more likely to eat raw fresh water fish that serves as a reservoir of Clonorchis Both disease-specific (A) and recurrence-free (B) survivals are well predicted by the category system.…”

Section: Discussionsupporting

confidence: 92%

Long-term clinical outcome of the surgically resected intraductal papillary neoplasm of the bile duct

Jung

Park

Lee

et al. 2012

Journal of Hepatology

102

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Section: Discussionsupporting

confidence: 92%

Long-term clinical outcome of the surgically resected intraductal papillary neoplasm of the bile duct

Jung

Park

Lee

et al. 2012

Journal of Hepatology

102

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“…Factors responsible for the development of cholangiocarcinoma may be partly mechanical stimuli from intrahepatic calculi and partly chemical irritation to the bile duct wall by infected bile [4,24]. Patients with cholangiocarcinoma generally have a poor prognosis, with an average 5-year survival rate of 5-10% [12,25]. Because surgery remains the only intervention offering the possibility of a cure [25], early detection of cholangiocarcinoma is essential in hepatolithiasis patients; early detection raises the chance that a patient can be included as a surgical candidate and may consequently improve their prognosis.…”

Section: Discussionmentioning

confidence: 99%

“…Alternatively, the percentage of patients with cholangiocarcinoma with concomitant hepatolithiasis has been reported to be in the range H of 17-27% [10][11][12]. Chronic irritation by intrahepatic calculi, bile stasis, and bacterial infection have been proposed as possible factors responsible for its development [6].…”

mentioning

confidence: 99%

CT Differentiation of Cholangiocarcinoma from Periductal Fibrosis in Patients with Hepatolithiasis

Park

Lee

Kim

et al. 2006

American Journal of Roentgenology

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OBJECTIVE. The objective of our study was to determine useful CT findings for differentiating cholangiocarcinoma from periductal fibrosis in patients with hepatolithiasis.MATERIALS AND METHODS. CT images of 30 patients with hepatolithiasis and pathologically proven cholangiocarcinoma (n = 14) or periductal fibrosis (n = 16) were retrospectively reviewed. Helical CT scans were obtained before, 30 seconds after, and 65 seconds after the start of contrast material injection. Analysis of CT findings included evaluation for the presence of periductal soft-tissue density, bile duct wall thickening at the stricture site, ascites, portal vein obliteration, lymph node enlargement, and a duct stone; assessment of the degree of ductal dilatation; and evaluation of the enhancement pattern of periductal lesions, thickened ductal wall, and hepatic parenchyma. The CT attenuation coefficients of the thickened ductal wall and adjacent normal-looking bile duct were measured on images obtained during each phase. Among these findings, statistically significant variables were determined using the Fisher's exact test and Student's t test. Sensitivity and specificity values of the CT criteria were also calculated.RESULTS. The presence of periductal soft-tissue density (p = 0.002), higher enhancement of the duct than adjacent bile duct on portal venous phase images (p = 0.008), ductal wall thickening (p = 0.026), portal vein obliteration (p = 0.031), and lymph node enlargement (p = 0.031) were found to be the significant findings for differentiating cholangiocarcinoma from fibrosis in patients with hepatolithiasis. When any two or more of these five criteria were used in combination, we could identify 100% of the patients with cholangiocarcinoma but only 12.5% of the patients with fibrosis.

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“…It arises from the intrahepatic bile ducts, and should be clearly distinguished from other types of cholangiocarcinoma arising from other sites within the biliary system, such as the main biliary confluence [1]. Risk factors such as congenital intrahepatic bile duct dilatation, intrahepatic lithiasis and fluke infection, which are widespread conditions in Southeast Asia, render these tumors much more common in Eastern countries than in the West [2,3]. IHC accounts for only 10-20% of primary hepatic malignancies and for 6% of all cholangiocarcinomas in Western countries, although an increasing incidence during the recent years has been observed [4,5].…”

Section: Introductionmentioning

confidence: 99%

Intrahepatic cholangiocarcinoma: prognostic factors after liver resection

et al. 2010

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Liver resection may represent the only hope of cure for patients with intrahepatic cholangiocarcinoma (IHC) but long-term results are still far from satisfactory and the impact of prognostic factors is still controversial. Fifty-five patients underwent hepatectomy for IHC between 1997 and 2008 in our unit. Features of the patients and the tumors, operations, postoperative and long-term results were retrospectively assessed. Twenty-one patients had HBV/HCV infection, four had congenital biliary dilatation. Thirty-two patients had increased CA 19-9; 12 had multiple (≥ 4) tumors. Operations included 43 major resections, with 9 resections of biliary confluence, 40 regional lymphadenectomies. Operative mortality and morbidity were 0 and 27.3%, respectively. There were 44 R0-resections (80.0%). Lymphadenectomy yielded lymph node metastases in 14 cases (14/40; 35.0%). Five-year overall and disease-free survival rates were 30.2 and 27.5%, respectively. At multivariate analysis the strongest poor prognostic factor for overall survival was tumor stage. This factor, with multiplicity of lesions (≥ 4) and tumor grading > 2, was significant predictor of recurrence. CA19-9 > 100 IU/mL and tumor grading > 2 were found to be significantly related with early multinodular hepatic recurrence. Patients with lymph node metastases had significantly lower overall and disease-free survival but patients who underwent lymph node dissection with negative lymph nodes at final pathology showed significantly higher 5-year disease-free survival than patients who did not underwent lymphadenectomy. In conclusion, these results support the role of hepatectomy with regional lymphadenectomy as the best available treatment for IHC. Prognosis after liver resection correlates with clinical stage and multiplicity of lesions.

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What is the impact of coexistence of hepatolithiasis on cholangiocarcinoma?

Abstract: The clinicopathological features of cholangiocarcinoma with concomitant hepatolithiasis showed few differences from that without hepatolithiasis. Resectability was the only predictor that favored a good prognosis.

Cited by 39 publications

References 19 publications

Long-term clinical outcome of the surgically resected intraductal papillary neoplasm of the bile duct

Long-term clinical outcome of the surgically resected intraductal papillary neoplasm of the bile duct

CT Differentiation of Cholangiocarcinoma from Periductal Fibrosis in Patients with Hepatolithiasis

Intrahepatic cholangiocarcinoma: prognostic factors after liver resection

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