title: Postoperative survival in intrahepatic cholangiocarcinoma showing intraductal growth.
abstract: Clinicopathologic variables favoring recurrence after hepatic resection for intrahepatic cholangiocarcinoma showing intraductal growth remain unclear. We investigated various clinicopathologic features in three patients who underwent resection for this type of intrahepatic cholangiocarcinoma. All underwent extended left hepatectomy plus resection of the caudate lobe and lymph node dissection. Lymph nodes showed no pathologic involvement. Although no cancer cells were seen in the mucosal layer by intraoperative pathologic examination at the bile duct stump in any patient, pathologic examination of resected specimens showed cancer cells invading beyond the mucosal layer in connective tissues surrounding the bile duct stump (interstitial invasion) of the Glisson's sheath in 2 patients. One of them died of cancer recurrence near the bile duct stump, while the third patient, without interstitial invasion, has survived for 10.6 years. In the intraductal growth type of intrahepatic cholangiocarcinoma, absence of cancer cells should be confirmed by intraoperative pathologic examination of not only the mucosal layer of the bile duct but also the connective tissue surrounding the bile duct, since interstitial invasion may be a risk factor for cancer recurrence.
authors.affiliation: Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan. m4011498@msic.med.osaka-cu.ac.jp
authors.forename: Seikan
authors.initials: S
authors.lastname: Hai
authors.forename: Shoji
authors.initials: S
authors.lastname: Kubo
authors.forename: Takahiro
authors.initials: T
authors.lastname: Uenishi
authors.forename: Takatsugu
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Hiromu
authors.initials: H
authors.lastname: Tanaka
authors.forename: Taichi
authors.initials: T
authors.lastname: Shuto
authors.forename: Shigekazu
authors.initials: S
authors.lastname: Takemura
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hirohashi
mesh_terms: D001652:Bile Ducts / Q000473:pathology*; D018281:Cholangiocarcinoma / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011184:Postoperative Period; D016019:Survival Analysis