title: Macroscopic types of intrahepatic cholangiocarcinoma: clinicopathologic features and surgical outcomes.
abstract: OBJECTIVE
  The prognosis of patients with intrahepatic cholangiocarcinoma is different for the different macroscopic types of this tumor. This study correlated clinicopathologic features and outcome after surgery with macroscopic types of intrahepatic cholangiocarcinoma to determine prognostic predictors.
  
  
  METHODS
  Resected intrahepatic cholangiocarcinomas were classified into the following growth types: mass-forming (n = 10), periductal-infiltrating (n = 11), mass-forming plus periductal-infiltrating (n = 14), and intraductal (n = 2). Intraductal tumors were not considered further. The prognostic significance of clinicopathologic features was determined by univariate and multivariate analyses.
  
  
  RESULTS
  Perineural invasion (P = 0.00051), lymphatic invasion (P = 0.0088), and positive resection margin (P = 0.028) were less frequent in patients with mass-forming tumors than with mass-forming plus periductal-infiltrating tumors. Patients with mass-forming plus periductal-infiltrating tumors had shorter survival than those with mass-forming tumors (P = 0.0072). By univariate analysis, an elevated serum carcinoembryonic antigen concentration, lymphatic invasion, lymph node metastasis, intrahepatic metastasis, and positive resection margin predicted shorter survival after surgery. An elevated serum carcinoembryonic antigen concentration, lymphatic invasion, and positive resection margin were independent prognostic factors on multivariate analysis. The macroscopic type did not correlate independently with prognosis.
  
  
  CONCLUSIONS
  Extended hepatic resection should be performed in patients with intrahepatic cholangiocarcinoma to obtain a tumor-free margin of resection.
authors: Second Department of Surgery, Osaka City University Medical School, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan. m2664791@msic.med.osaka-cu.ac.jp
authors: Kazuhiro
authors: K
authors: Hirohashi
authors: Takahiro
authors: T
authors: Uenishi
authors: Shoji
authors: S
authors: Kubo
authors: Takatsugu
authors: T
authors: Yamamoto
authors: Hiromu
authors: H
authors: Tanaka
authors: Taichi
authors: T
authors: Shuto
authors: Hiroaki
authors: H
authors: Kinoshita
mesh_terms: D000328:Adult; D000368:Aged; D001650:Bile Duct Neoplasms / Q000097:blood / Q000401:mortality* / Q000473:pathology*; D001653:Bile Ducts, Intrahepatic; D002272:Carcinoembryonic Antigen / Q000097:blood; D018281:Cholangiocarcinoma / Q000097:blood / Q000401:mortality* / Q000473:pathology*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D002272:Carcinoembryonic Antigen