A Western surgical experience of peripheral cholangiocarcinoma

Berdah, Stéphane; Delpero, Jean‐Robert; Garcia, S.; Hardwigsen, Jean; Treut, Y. P. Le

doi:10.1002/bjs.1800831108

Cited by 87 publications

(51 citation statements)

References 19 publications

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“…The English-language literature on PCC has reported only a few long-term survivors, 10,23 and the 5-year survival rate after curative resection has been reported to be approximately 40%. [3][4][5][6][7][8][9]24 Compared with other series of PCC, the IG type had a much better prognosis.…”

Section: Discussionmentioning

confidence: 99%

“…1 Because the lesion is advanced by the time of diagnosis, 2 the possibility of surgical resection is limited and the prognosis is generally poor. [3][4][5][6][7][8][9] In 1992, Yamamoto et al 10 classified PCC into 2 types, mass-forming (MF) and periductal-infiltrating (PI), and showed their different clinical behaviors. The MF type creates an apparent lesion in the liver, with frequent remnant hepatic recurrence after resection.…”

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confidence: 99%

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Clinicopathologic features of the intraductal growth type of peripheral cholangiocarcinoma

et al. 2000

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The clinicopathologic features of the intraductal growth (IG) type of peripheral cholangiocarcinoma (PCC) were examined retrospectively. Out of 112 patients who underwent surgery for PCC at Seoul National University Hospital, Seoul, Korea, between January 1980 and December 1997, 16 were classified as having the IG type. Thirteen were men and 3 were women. Their ages ranged from 38 to 73 years with a mean age of 55.9 years. Abdominal pain was the most common symptom and jaundice was found in 18.8%. Five patients had associated clonorchiasis and 6 patients experienced hepatolithiasis. Tumor sizes ranged from 0.5 cm to 14.0 cm with a mean of 4.3 cm. The tumor was located in the right lobe in 7 cases and the left lobe in 9 cases. Thirteen patients underwent major hepatic resection, and 3 underwent minor resection, involving a subsegmentectomy. Mucin was found in the bile in 4 cases. Pathology showed papillary adenocarcinoma with a background of adenomatous hyperplasia, and the absence of lymph node metastasis in all cases. The tumors were confined to the mucosa in 5 cases. Out of the 16 hepatic resections, 1 was palliative due to a positive margin. In 2 of the patients who underwent minor resections, recurrences developed, and 1 of these died 56 months after resection. Out of the 16 patients, 15 remain alive, ranging from 1 to 13 years, postoperatively. In conclusion, the IG type of PCC should be distinguished from other types of PCC because a favorable prognosis can be expected after complete surgical resection. (HEPATOLOGY 2000;31:12-17.)Intrahepatic or peripheral cholangiocarcinoma (PCC), a primary adenocarcinoma of the liver originating from the intrahepatic bile ducts (IHD), is the second most common primary hepatic malignancy, next to hepatocellular carcinoma. 1 Because the lesion is advanced by the time of diagnosis, 2 the possibility of surgical resection is limited and the prognosis is generally poor. [3][4][5][6][7][8][9] In 1992, Yamamoto et al. 10 classified PCC into 2 types, mass-forming (MF) and periductal-infiltrating (PI), and showed their different clinical behaviors. The MF type creates an apparent lesion in the liver, with frequent remnant hepatic recurrence after resection. The PI type causes a stricture or an obstruction of the IHD without forming a definite mass in the liver. It spreads along the Glisson' s capsule and metastasizes to the hilar lymph nodes. Later, another type, intraductal growth (IG), was added. 11 This type of tumor shows a papillary growth into the lumen of the bile duct. 12 There have been a few scattered reports about the clinical and pathological features of the IG type of PCC. 13,14 Here, we describe the clinical and pathological features of the IG type of PCC in 16 patients who underwent surgical resection at

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Section: Discussionmentioning

confidence: 99%

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Clinicopathologic features of the intraductal growth type of peripheral cholangiocarcinoma

et al. 2000

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“…A partial hepatectomy with removal of the involved bile ducts is performed. Five year patient survival ranges from approximately 20-43%, the higher survival stems from careful patient selection (61)(62)(63)(64). In the remainder, recurrent disease is the norm.…”

Section: Therapy Curative Surgical Resectionmentioning

confidence: 99%

Cholangiocarcinoma: Modern advances in understanding a deadly old disease

Malhi

Gores

2006

Journal of Hepatology

243

193

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Cholangiocarcinomas are tumors that arise anywhere in the biliary tract, presumably of cholangiocyte origin. The global incidence of this rare disease is on the rise. Several known risk factors exist, and link chronic biliary inflammation to the pathogenesis of cholangiocarcinoma. Among these, amplification of the epidermal growth factor receptor, the interleukin-6 signaling pathway, inducible nitric oxide, erb-2, and cyclooxygenase-2 are well defined. Most patients present late, with a median survival of months. Although, imaging studies and clinical context often indicate cholangiocarcinoma, pathologic and cytologic diagnosis is difficult to obtain. Advanced cytologic tests with fluorescent in situ hybridization or digital image analysis can increase diagnostic sensitivity. Surgical resection is the current therapy of choice for both intrahepatic and ductal cholangiocarcinomas. However, the 5 year survival is poor, with 60 to greater than 90% recurrence rates. In a single center experience, liver transplantation with neoadjuvant chemoirradiation, for highly selected patients has a 5 year disease free survival of greater than 80%. Future targeted therapies will depend on a better understanding of the cellular and molecular biology of cholangiocarcinomas.

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“…The prognosis of patients with IHCC is generally poor due to the advanced stage of the disease at presentation [5,6]. Following diagnosis, the majority of patients with IHCC have a reported median survival of less than 9 months [7,8]. Nevertheless, recent published literature has shown that aggressive surgical resection does improve long-term survival in selected cases [9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%