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Serosal invasion in TNM staging of mass-forming intrahepatic cholangiocarcinoma

  • Published:
Journal of Hepato-Biliary-Pancreatic Surgery

Abstract

Background/Purpose

The Liver Cancer Study Group of Japan established a tumor-nodule-metastasis (TNM) staging system for mass-forming intrahepatic cholangiocarcinoma, with T determined by tumor number and size and vascular or serosal invasion. Serosal invasion is not considered in the designation established by the International Union Against Cancer.

Methods

Sixty-three patients who underwent hepatic resection for mass-forming intrahepatic cholangiocarcinoma were investigated retrospectively, with the investigation including univariate and multivariate analyses of potential prognostic factors.

Results

By log-rank test, tumor size more than 3.0 cm, vascular invasion, lymph node metastasis, intrahepatic metastasis, and involved resection margin, but not serosal invasion, were associated significantly with poor prognosis. Even in patients with serosal invasion, the postoperative outcome was much better in those without than in those with vascular invasion. Multivariate analysis identified vascular invasion, lymph node metastasis, and an involved resection margin as independent prognostic factors. When serosal invasion was excluded from tumor staging, the 5-year survival rates became more clearly stratified: 100% in those with stage I disease, 62% in those with stage II, 25% in those with stage III, and 7% for patients with stage IV.

Conclusions

Serosal invasion showed no survival impact after hepatic resection for mass-forming intrahepatic cholangiocarcinoma. When serosal invasion was omitted from the TNM staging proposed by the Liver Cancer Study Group of Japan, stratification of postoperative survival between stages was more effective.

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Authors and Affiliations

  1. Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan

    Takahiro Uenishi, Kazuhiro Hirohashi, Hiromu Tanaka, Shogo Tanaka, Seikan Hai & Shoji Kubo

  2. Department of Gastrointestinal Surgery, Osaka City General Hospital, Osaka, Japan

    Osamu Yamazaki

  3. Department of Surgery, Ishikiri Seiki Hospital, Osaka, Japan

    Takahiro Uenishi & Takatsugu Yamamoto

Authors
  1. Takahiro Uenishi
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  2. Osamu Yamazaki
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  3. Takatsugu Yamamoto
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  4. Kazuhiro Hirohashi
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  5. Hiromu Tanaka
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  6. Shogo Tanaka
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  7. Seikan Hai
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  8. Shoji Kubo
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Uenishi, T., Yamazaki, O., Yamamoto, T. et al. Serosal invasion in TNM staging of mass-forming intrahepatic cholangiocarcinoma. J Hepatobiliary Pancreat Surg 12, 479–483 (2005). https://doi.org/10.1007/s00534-005-1026-8

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  • DOI: https://doi.org/10.1007/s00534-005-1026-8

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