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Impact of tumor localization on the outcomes of surgery for an intrahepatic cholangiocarcinoma

  • Original Article—Liver, Pancreas, and Biliary Tract
  • Published:
  • volume 53, pages 1206–1215 (2018)
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Abstract

Background

Intrahepatic cholangiocarcinoma (ICC) shows differing clinical outcomes depending on its localization.

Methods

We reviewed the surgical outcomes of 104 ICC patients who underwent liver resection at our institution. We divided ICC into hilar type (HICC) and peripheral type (PICC) depending on positive contact with the hepatic hilum on preoperative computed tomography (CT).

Results

The survival outcomes were significantly poorer in HICC patients. HICCs showed a larger tumor size and more frequent bile duct invasion, lymph node metastasis, and non-curative resection than PICC. Resections for HICC had greater blood loss and required a longer operation time, larger hepatectomy, and more frequent extrahepatic bile duct resection. HICCs, even if small in size, also showed a greater tendency to metastasize to the lymph nodes of the hepatoduodenal ligament. Univariate analysis of the ICCs in our current cohort revealed that tumor size, multiple tumors, bile duct invasion, lymph node metastasis, non-curative resection, and HICC are associated with a poorer overall survival outcome. Multivariate analysis indicated that multiple tumors and non-curative resection were independent prognostic factors for survival. Among the curative resection cases, however, survival did not differ significantly between HICC and PICC. The accuracy rate of our CT-based classification for the pathological classification was 81.7%.

Conclusions

HICC shows more frequent bile duct invasion and lymph node metastasis, requires more extensive surgery, and has a higher rate of non-curative resection than PICC. However, if curative resection is achieved, the survival outcomes are expected to be equivalent between HICC and PICC.

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Fig. 1
Fig. 2

Abbreviations

ICC:

Intrahepatic cholangiocarcinoma

HICC:

Hilar-type intrahepatic cholangiocarcinoma

PICC:

Peripheral-type intrahepatic cholangiocarcinoma

CT:

Computed tomography

ICGR15:

Indocyanine green retention rate at 15 min

5FU:

5-Fluorouracil

CA 19-9:

Carbohydrate antigen 19-9

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Authors and Affiliations

  1. Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, North 15-West 7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan

    Tatsuya Orimo, Toshiya Kamiyama, Hirofumi Kamachi, Hideki Yokoo, Kenji Wakayama, Shingo Shimada, Akihisa Nagatsu & Akinobu Taketomi

  2. Department of Surgical Pathology, Hokkaido University Hospital, Sapporo, Japan

    Tomoko Mitsuhashi

Authors
  1. Tatsuya Orimo
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  2. Toshiya Kamiyama
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  4. Hirofumi Kamachi
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  6. Kenji Wakayama
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  7. Shingo Shimada
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  9. Akinobu Taketomi
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Correspondence to Tatsuya Orimo.

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Orimo, T., Kamiyama, T., Mitsuhashi, T. et al. Impact of tumor localization on the outcomes of surgery for an intrahepatic cholangiocarcinoma. J Gastroenterol 53, 1206–1215 (2018). https://doi.org/10.1007/s00535-018-1469-8

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  • DOI: https://doi.org/10.1007/s00535-018-1469-8

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