title: The favorable prognosis after operative resection of hypervascular intrahepatic cholangiocarcinoma: A clinicopathologic and immunohistochemical study.
abstract: The aim of this study was to clarify the clinicopathologic characteristics of hypervascular intrahepatic cholangiocarcinoma (ICC).
  
  
  
  Seventy patients with a mass-forming type ICC underwent hepatectomy between 2003 and 2013. These patients were divided into 2 groups and compared based on findings during the late arterial phase of computed tomography: hypervascular ICC (the mean computed tomography value of the tumor ≥ that of the nontumorous liver parenchyma, n = 21), and hypovascular ICC (n = 49).
  
  
  
  The overall survival of the hypervascular group was better than that of the hypovascular group (5-year survival: 63% vs 35%, respectively, P = .046). Pathologic examinations showed less lymph node metastasis (0% vs 39%), lymphatic invasion (14% vs 57%), mucin secretion (19% vs 61%), tumor necrosis (24% vs 57%), and combined periductal infiltration (0% vs 27%), P ≤ .01 each, in the hypervascular group. The microscopic bile ductular feature was more frequent in the hypervascular group (57% vs 29%, P = .023). Immunohistochemical analysis revealed that the hypervascular group had greater immunoreactivity to neural cell adhesion molecule (71% vs 37%, P = .008) and a lesser S100P immunoreactivity (33% vs 73%, P = .002). Multivariate analysis revealed that neural cell adhesion molecule reactivity (P = .018) was independently associated with the hypervascular group.
  
  
  
  Tumor vascularity predicts the aggressiveness of ICC. In most patients with hypervascular ICC, the tumor has a less invasive nature. Furthermore, the prognosis after resection in patients with hypervascular ICC is significantly better than in patients with hypovascular ICC.
authors.affiliation: Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, Shizuoka, Japan; Department of General Surgery, Akdeniz University, Antalya, Turkey.
authors.forename: Mehmet Akif
authors.initials: MA
authors.lastname: Türkoğlu
authors.affiliation: Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, Shizuoka, Japan. Electronic address: yusu.yamamoto@scchr.jp.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Yamamoto
authors.affiliation: Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, Shizuoka, Japan.
authors.forename: Teiichi
authors.initials: T
authors.lastname: Sugiura
authors.affiliation: Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, Shizuoka, Japan.
authors.forename: Yukiyasu
authors.initials: Y
authors.lastname: Okamura
authors.affiliation: Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, Shizuoka, Japan.
authors.forename: Takaaki
authors.initials: T
authors.lastname: Ito
authors.affiliation: Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, Shizuoka, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Ashida
authors.affiliation: Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, Shizuoka, Japan.
authors.forename: Sunao
authors.initials: S
authors.lastname: Uemura
authors.affiliation: Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, Shizuoka, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Miyata
authors.affiliation: Division of Pathology, Shizuoka Cancer Center, Shizuoka, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kakuda
authors.affiliation: Division of Pathology, Shizuoka Cancer Center, Shizuoka, Japan.
authors.forename: Yasuni
authors.initials: Y
authors.lastname: Nakanuma
authors.affiliation: Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, Shizuoka, Japan.
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Uesaka
mesh_terms: D001650:Bile Duct Neoplasms / Q000098:blood supply* / Q000175:diagnosis* / Q000601:surgery; D001653:Bile Ducts, Intrahepatic; D018281:Cholangiocarcinoma / Q000098:blood supply* / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed