title: Clinical Significances of Preoperative Classification of Intrahepatic Cholangiocarcinoma: Different Characteristics of Perihilar vs. Peripheral ICC.
abstract: The aim of this study was to evaluate the clinical significance of preoperative classification of intrahepatic cholangiocarcinoma (ICC) into perihilar and peripheral types using dynamic computed tomography (CT).
  
  
  
  A retrospective cohort study was performed to analyze the differences in clinical characteristics between perihilar and peripheral ICC samples from patients between 1990-2014.
  
  
  
  A total of 87 patients were divided into three ICC subtypes; perihilar (n=34), peripheral (n=44), and unclassifiable ICC (n=9). The positive rates of pathological lymphatic infiltration (ly) (p=0.02) and perineural invasion (pn) (p<0.0001) were significantly higher in perihilar ICC. There was no significant difference in the disease-free survival rate (p=0.2268); however, the overall survival rate of perihilar ICC was significantly worse (p=0.0031). The rate of systemic recurrence (>3 nodules) was significantly higher in perihilar ICC (p=0.0135).
  
  
  
  In perihilar ICC, the local tumor invasions such as ly and pn were more frequent. Therefore, it is important in such cases to attempt to achieve a sufficient tumor margin. Systemic recurrences were more frequent in perihilar ICC, so perioperative chemotherapy should be conducted as well.
authors.affiliation: Department of Gastroenterological Surgery, Kumamoto University, Kumamoto, Japan y-yama@kumamoto-u.ac.jp.|Department of Hepato-Biliary-Pancreatic Surgery, National Kyushu Cancer Center, Fukuoka, Japan.
authors.forename: Yo-Ichi
authors.initials: YI
authors.lastname: Yamashita
authors.affiliation: Department of Surgery and Science, Kyushu University, Fukuoka, Japan.
authors.forename: Huanlin
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Surgery and Science, Kyushu University, Fukuoka, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kurihara
authors.affiliation: Department of Hepato-Biliary-Pancreatic Surgery, National Kyushu Cancer Center, Fukuoka, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Tsujita
authors.affiliation: Department of Clinical Radiology, Kyushu University, Fukuoka, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Nishie
authors.affiliation: Department of Gastroenterological Surgery, Kumamoto University, Kumamoto, Japan.
authors.forename: Katsunori
authors.initials: K
authors.lastname: Imai
authors.affiliation: Department of Gastroenterological Surgery, Kumamoto University, Kumamoto, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Hashimoto
authors.affiliation: Department of Gastroenterological Surgery, Kumamoto University, Kumamoto, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Chikamoto
authors.affiliation: Department of Pathology and Microbiology, Saga University, Saga, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Aishima
authors.affiliation: Department of Gastroenterological Surgery, Kumamoto University, Kumamoto, Japan.
authors.forename: Hideo
authors.initials: H
authors.lastname: Baba
mesh_terms: D000368:Aged; D001650:Bile Duct Neoplasms / Q000145:classification / Q000000981:diagnostic imaging / Q000473:pathology*; D018281:Cholangiocarcinoma / Q000145:classification / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
keywords: Intrahepatic cholangiocarcinoma; perihilar type; peripheral type