title: Correlation between tumor size and mode of spread in mass-forming intrahepatic cholangiocarcinoma.
abstract: OBJECTIVE
  Mode of spread of intrahepatic cholangiocarcinoma of the mass-forming type (MF-ICC) has not been assessed according to tumor size.
  
  
  METHODS
  We retrospectively evaluated 17 cases of resected MF-ICCs. Tumor size was categorized as follows: < 45 mm (n=4), 45-79 mm (n=7), and > or = 80 mm (n=6). The correlation of tumor size with presence or absence of histological invasion to the portal vein (vp), hepatic vein (vv), intrahepatic metastasis (im), and lymphatic vessel or perineural space (ly/pn) was evaluated. Clinical outcomes of 13 patients who underwent curative resection were also investigated.
  
  
  RESULTS
  The positive rates of vp, vv, im, and ly/pn were calculated as 25, 0, 0, and 0% in the < 45-mm group; 86, 29, 86, and 71% in the 45-79-mm group; and 100, 50, 83, and 83% in the > or = 80-mm group, respectively. Of 13 patients who underwent curative resection, 6 of 9 in the > 45-mm group were found to have recurrent diseases in the liver remnant, lymph node, and the lung, whereas one of 4 patients in the < 40-mm group developed peritoneal recurrence.
  
  
  CONCLUSIONS
  Systematic hepatectomy without lymphadenectomy might be appropriate for MF-ICC smaller than 45 mm in diameter.
authors.affiliation: Department of Surgery I, Oita Medical University, Oita, Japan. sasakia@med.oita_u.ac.jp
authors.forename: Atsushi
authors.initials: A
authors.lastname: Sasaki
authors.forename: Katsunori
authors.initials: K
authors.lastname: Kawano
authors.forename: Masanori
authors.initials: M
authors.lastname: Aramaki
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Ohno
authors.forename: Koichiro
authors.initials: K
authors.lastname: Tahara
authors.forename: Seigo
authors.initials: S
authors.lastname: Kitano
mesh_terms: D000368:Aged; D001650:Bile Duct Neoplasms / Q000473:pathology*; D001653:Bile Ducts, Intrahepatic; D002454:Cell Differentiation; D018281:Cholangiocarcinoma / Q000473:pathology*; D005260:Female; D006503:Hepatic Veins / Q000473:pathology; D006801:Humans; D008099:Liver / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011169:Portal Vein / Q000473:pathology; D012189:Retrospective Studies