Assessment of pathology reports on hilar cholangiocarcinoma: The results of a nationwide, multicenter survey performed by the AFC-HC-2009 study group

Chatelain, Denis; Farges, Olivier; Fuks, David; Pruvot, F.R.; Régimbeau, Jean-Marc

doi:10.1016/j.jhep.2011.12.010

Cited by 28 publications

(24 citation statements)

References 25 publications

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“…An additional caudate lobe resection is recommended because direct infiltration along this lobe's bile ducts is reportedly responsible for a high rate of local recurrence . Our rate of R1 resection was significantly higher in our French series compared with the Italian's after a liver resection (41% versus 21%) and had been recently validated after a meticulous pathological analysis . Although we would have expected that tumours >30 mm predict a R1 resection and therefore poor outcomes, multivariate analysis failed to find an association between surgical margins and early deaths.…”

Section: Discussionmentioning

confidence: 58%

“…In brief, the extrahepatic bile duct of the resected specimen was opened longitudinally from the distal resection margin up to the proximal margin, to accurately evaluate the ductal margin status. All surgical specimen slides were not available for review; however, a copy of the histology report on the tumour specimen was requested for each patient . All pathology reports were reviewed by an independent pathologist (D.C.).…”

Section: Methodsmentioning

confidence: 99%

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Tumour size over 3 cm predicts poor short-term outcomes after major liver resection for hilar cholangiocarcinoma. By the HC-AFC-2009 group

Régimbeau

Fuks

Pessaux

et al. 2015

HPB

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Section: Discussionmentioning

confidence: 58%

Section: Methodsmentioning

confidence: 99%

Tumour size over 3 cm predicts poor short-term outcomes after major liver resection for hilar cholangiocarcinoma. By the HC-AFC-2009 group

Régimbeau

Fuks

Pessaux

et al. 2015

HPB

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“…Tumour differentiation was missing in 27% of cases, vascular invasion in 45% and infiltration of the bile duct surgical margins in 4% of the reports. Moreover, distances between the tumour and the vessel margin, liver margin and the periductal soft tissue circumferential margin were not specified in 87%, 79% and 89% of cases respectively . The inadequacy of reporting may be key to explaining the finding that even after R0 resection (local) recurrence rates have been reported to be more than 50% .…”

Section: Current Problems In Diagnostic Pathology Of Ccamentioning

confidence: 99%

Anatomical, histomorphological and molecular classification of cholangiocarcinoma

Kendall

Verheij

Gaudio

et al. 2019

Liver International

240

210

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Cholangiocarcinoma constitutes a heterogeneous group of malignancies that can emerge at any point of the biliary tree. Cholangiocarcinoma is classified into intrahepatic, perihilar and distal based on its anatomical location. Histologically, conventional perihilar/distal cholangiocarcinomas are mucin‐producing adenocarcinomas or papillary tumours; intrahepatic cholangiocarcinomas are more heterogeneous and can be sub‐classified according to the level or size of the displayed bile duct. Cholangiocarcinoma develops through multistep carcinogenesis and is preceded by dysplastic and in situ lesions. Definition and clinical significance of precursor lesions, including biliary intraepithelial neoplasia, intraductal papillary neoplasms of the bile duct, intraductal tubulopapillary neoplasms and mucinous cystic neoplasm, are discussed in this review. A main challenge in diagnosing cholangiocarcinoma is the fact that tumour tissue for histological examination is difficult to obtain. Thus, a major clinical obstacle is the establishment of the correct diagnosis at a tumour stage that is amenable to surgery which still represents the only curable therapeutic option. Current standards, methodology and criteria for diagnosis are discussed. Cholangiocarcinoma represents a heterogeneous tumour with regard to molecular alterations. In intrahepatic subtype, mainly two distinctive morpho‐molecular groups can currently be discriminated. Large‐duct type intrahepatic cholangiocarcinoma shows a high mutation frequency of oncogenes and tumour suppressor genes, such as KRAS and TP53 while Isocitrate Dehydrogenase 1/2 mutations and Fibroblast Growth Factor Receptor 2‐fusions are typically seen in small‐duct type tumours. It is most important to ensure the separation of the given anatomical subtypes and to search for distinct subgroups within the subtypes on a molecular and morphological basis.

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“…In 2018, a consensus guideline was published by the International Collaboration on Cancer Reporting (ICCR), containing the essential parameters to be incorporated in the pathology report for cholangiocarcinoma [20]. It states that in PHC, R0 means a tumor-free margin of ≥ 1 mm, as distance in millimeters between the tumor and resection or dissection plane is prognostic for survival [21–23]. However, many authors have shown that reporting on margin status and standard parameters is frequently incomplete [20, 24–27].…”

Section: Introductionmentioning

confidence: 99%

“…1). Although the authors have chosen to refer to this dissection margin as periductal dissection plane, others have reported this as (circumferential) dissection margin [22] or periductal soft tissue circumferential margin [21]. The periductal dissection plane consists of a circumferential surgical dissection plane, opposed to the peritoneal surface on the other side (see Fig.…”

Section: Introductionmentioning

confidence: 99%

Lost in translation: confusion on resection and dissection planes hampers the interpretation of pathology reports for perihilar cholangiocarcinoma

et al. 2019

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In perihilar cholangiocarcinoma (PHC), interpretation of the resection specimen is challenging for pathologists and clinicians alike. Thorough and correct reporting is necessary for reliable interpretation of residual disease status. The aim of this study is to assess completeness of PHC pathology reports in a single center and assess what hampers interpretation of pathology reports by clinicians. Pathology reports of patients resected for PHC at a single expert tertiary center drafted between 2000 and 2018 were assessed. Reports were assessed regarding completeness, according to the guideline of the International Collaboration on Cancer Reporting (ICCR). A total of 146 reports were assessed. Prognostic tumor characteristics such as vasoinvasive growth and perineural growth were missing in 30/146 (34%) and 22/146 (15%), respectively. One or more planes were missing in 94/146 (64%) of the reports, with the periductal dissection plane missing in 51/145 (35%). Residual disease could be re-classified from R0 to R1 in 22 patients (15%). Reasons for R1 in these patients were the presence of a positive periductal dissection plane (n = 2), < 1-mm margin at the periductal dissection plane (n = 11), or liver parenchyma (n = 9). Completeness of reports improved significantly when drafted by an expert HPB pathologist. This study demonstrates that pathology reporting of PHC is challenging. Reports are frequently incomplete and often do not incorporate assessment of all resection planes and the dissection plane. The periductal dissection plane is frequently overlooked, but is a major cause of residual disease.

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Assessment of pathology reports on hilar cholangiocarcinoma: The results of a nationwide, multicenter survey performed by the AFC-HC-2009 study group

Cited by 28 publications

References 25 publications

Tumour size over 3 cm predicts poor short-term outcomes after major liver resection for hilar cholangiocarcinoma. By the HC-AFC-2009 group

Tumour size over 3 cm predicts poor short-term outcomes after major liver resection for hilar cholangiocarcinoma. By the HC-AFC-2009 group

Anatomical, histomorphological and molecular classification of cholangiocarcinoma

Lost in translation: confusion on resection and dissection planes hampers the interpretation of pathology reports for perihilar cholangiocarcinoma

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