Intrahepatic cholangiocarcinoma: clinicopathological differences between peripheral type and hilar type.
BACKGROUND
Intrahepatic cholangiocarcinoma (ICC) is categorized as peripheral ICC (PICC) or hilar ICC (HICC). The aims of this study are to clarify clinicopathological differences between PICC and HICC and to determine useful prognostic factors for patients with ICC following aggressive surgical resection.


METHODS
Medical records of 44 patients with ICC who underwent surgical resection were retrospectively reviewed. Clinicopathological factors were compared between patients with PICC and HICC. Univariate and multivariate models were used to analyze the effect of clinicopathological factors on disease-specific survival.


RESULTS
Disease-specific survival rates for the 44 patients were 76% at 1 year, 60% at 3 years, and 47% at 5 years. Clinicopathological factors did not differ between patients with PICC and HICC except preoperative jaundice (P<0.001), preoperative biliary drainage (P=0.001), postoperative complication (P=0.046), and macroscopic type (P<0.001). Multivariate analysis revealed that only lymph node status was an independent prognostic factor of disease-specific survival. The 5-year disease-specific survival rates of patients with or without nodal involvement were 23% and 66%, respectively (P=0.004).


CONCLUSIONS
Clinicopathological characteristics are almost similar between patients with PICC and HICC. Nodal involvement is a potent prognostic factor for patients with ICC.
Department of Surgery, Division of Clinical Medical Science, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan. mura777@hiroshima-u.ac.jp
Yoshiaki
Y
Murakami
Kenichiro
K
Uemura
Takeshi
T
Sudo
Yasushi
Y
Hashimoto
Akira
A
Nakashima
Taijiro
T
Sueda
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000473:pathology* / Q000601:surgery; D001653:Bile Ducts, Intrahepatic; D018281:Cholangiocarcinoma / Q000473:pathology* / Q000601:surgery; D003937:Diagnosis, Differential; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies