title: "Very early" intrahepatic cholangiocarcinoma in cirrhotic patients: should liver transplantation be reconsidered in these patients?
abstract: A retrospective cohort multicenter study was conducted to analyze the risk factors for tumor recurrence after liver transplantation (LT) in cirrhotic patients found to have an intrahepatic cholangiocarcinoma (iCCA) on pathology examination. We also aimed to ascertain whether there existed a subgroup of patients with single tumors ≤2 cm ("very early") in which results after LT can be acceptable. Twenty-nine patients comprised the study group, eight of whom had a "very early" iCCA (four of them incidentals). The risk of tumor recurrence was significantly associated with larger tumor size as well as larger tumor volume, microscopic vascular invasion and poor degree of differentiation. None of the patients in the "very early" iCCA subgroup presented tumor recurrence compared to 36.4% of those with single tumors >2 cm or multinodular tumors, p = 0.02. The 1-, 3- and 5-year actuarial survival of those in the "very early" iCCA subgroup was 100%, 73% and 73%, respectively. The present is the first multicenter attempt to ascertain the risk factors for tumor recurrence in cirrhotic patients found to have an iCCA on pathology examination. Cirrhotic patients with iCCA ≤2 cm achieved excellent 5-year survival, and validation of these findings by other groups may change the current exclusion of such patients from transplant programs.
authors.affiliation: Department of HBP Surgery and Transplantation, Hospital Universitario Vall d'Hebron, Universidad Autónoma de Barcelona, Barcelona, Spain.
authors.forename: G
authors.initials: G
authors.lastname: Sapisochin
authors.forename: C
authors.initials: C
authors.lastname: Rodríguez de Lope
authors.forename: M
authors.initials: M
authors.lastname: Gastaca
authors.forename: J
authors.initials: J
authors.lastname: Ortiz de Urbina
authors.forename: M A
authors.initials: MA
authors.lastname: Suarez
authors.forename: J
authors.initials: J
authors.lastname: Santoyo
authors.forename: J F
authors.initials: JF
authors.lastname: Castroagudín
authors.forename: E
authors.initials: E
authors.lastname: Varo
authors.forename: R
authors.initials: R
authors.lastname: López-Andujar
authors.forename: F
authors.initials: F
authors.lastname: Palacios
authors.forename: G
authors.initials: G
authors.lastname: Sanchez Antolín
authors.forename: B
authors.initials: B
authors.lastname: Perez
authors.forename: A
authors.initials: A
authors.lastname: Guiberteau
authors.forename: G
authors.initials: G
authors.lastname: Blanco
authors.forename: M L
authors.initials: ML
authors.lastname: González-Diéguez
authors.forename: M
authors.initials: M
authors.lastname: Rodriguez
authors.forename: M A
authors.initials: MA
authors.lastname: Varona
authors.forename: M A
authors.initials: MA
authors.lastname: Barrera
authors.forename: Y
authors.initials: Y
authors.lastname: Fundora
authors.forename: J A
authors.initials: JA
authors.lastname: Ferron
authors.forename: E
authors.initials: E
authors.lastname: Ramos
authors.forename: J
authors.initials: J
authors.lastname: Fabregat
authors.forename: R
authors.initials: R
authors.lastname: Ciria
authors.forename: S
authors.initials: S
authors.lastname: Rufian
authors.forename: A
authors.initials: A
authors.lastname: Otero
authors.forename: M A
authors.initials: MA
authors.lastname: Vazquez
authors.forename: J A
authors.initials: JA
authors.lastname: Pons
authors.forename: P
authors.initials: P
authors.lastname: Parrilla
authors.forename: G
authors.initials: G
authors.lastname: Zozaya
authors.forename: J I
authors.initials: JI
authors.lastname: Herrero
authors.forename: R
authors.initials: R
authors.lastname: Charco
authors.forename: J
authors.initials: J
authors.lastname: Bruix
mesh_terms: D000328:Adult; D000368:Aged; D001650:Bile Duct Neoplasms / Q000150:complications / Q000401:mortality / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic / Q000601:surgery*; D018281:Cholangiocarcinoma / Q000150:complications / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000401:mortality / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000517:prevention & control*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate
keywords: Intrahepatic cholangiocarcinoma; liver transplantation; outcome; “very early”