Prognostic significance of mucinous component in hilar cholangiocarcinoma after curative‐intent resection

Abstract

Background The presence of mucinous component has been indicated to have a prognostic value in adenocarcinoma. However, little is known regarding the clinicopathological characteristics and prognosis of hilar cholangiocarcinoma (HC) with mucinous component (HCM). Methods Between January 1996 and December 2014, a total of 61 HCM patients who underwent curative‐intent resection at West China Hospital were retrospectively reviewed. The clinicopathological characteristics and survival of these patients were compared with a large cohort of 217 surgically resected conventional HC patients during the same period. Results The clinicopathological characteristics of HCM were distinct from conventional HC, including higher CA19‐9 levels, larger tumor sizes, less differentiation, and a high frequency of liver parenchyma invasion, portal vein invasion, and lymphovascular invasion. HCM patients showed significantly worse recurrence‐free survival (13.4 vs 23.9 months; P = .011) and overall survival (18.2 vs 32.1 months; P = .019) compared with conventional HC patients. Multivariate analysis confirmed liver parenchyma invasion, N stage, surgical margin, and histological grade as independent prognostic factors influencing overall survival in HCM patients. Conclusion HCM showed distinct clinicopathological features, more aggressive biological behaviors, and poor prognosis in comparison with conventional HC. Therefore, the mucinous component is an adverse prognostic factor for HC.

Survival analysis of patients with stage T2a and T2b perihilar cholangiocarcinoma treated with radical resection

“…A panel of clinicopathologic factors have been reported to influence survival of pCCA after curative intent resection [ 12 , 25 , 26 ]. In the current study, high level of preoperative AST (≥85.0 IU/L), high level of preoperative CA19–9 (≥1000 U/mL), vascular resection and poor differentiation of the tumor remained as independent predictors for poor survival, which were in line with previous researches [ 27 – 30 ].…”

Survival analysis of patients with stage T2a and T2b perihilar cholangiocarcinoma treated with radical resection

“…[11,18,23] A panel of clinicopathologic factors have been reported to in uence survival of pCCA after curative intent resection. [12,25,26] In the current study, high level of preoperative AST (≥85.0IU/L), high level of preoperative CA19-9 (≥1000 U/mL), vascular resection and poor differentiation of the tumor remained as independent predictors for poor survival, which were in line with previous researches [27][28][29][30] The lymph node status have been reported as one of the most important independent prognostic predictor for patients undergoing hepatectomy for pCCA. [17,31] In the present research, N-staging was associated with survival in the univariate analysis, while did not remain as independent predictors of poor survival in multivariate analysis, which maybe attribute to the confounding effect of tumor differentiation.…”

Pathological aspects of mucinous cholangiocarcinoma: A single‐center experience and systematic review

“…8 The presence of a mucinous component in hilar CCAs is also associated with worse prognosis, including decreased recurrence-free survival and overall survival. 35 Nevertheless, the 1-year mortality rate of mucinous iCCAs in our four cases and the other 19 cases in the previously published literature is 35%, which is far lower than that of CCAs included in a nationwide study in Thailand (1-year mortality rate = 81.68%). 5 Similarly, a clinicopathological comparison between mucinous and conventional iCCAs in a series from the United States showed that the 1year survival rate of such a rare variant is comparable to that of the conventional counterpart (25% vs. 27%).…”

“…A large series from China reported that there was no significant difference in operation time, intraoperative blood loss, transfusion, and chemotherapy between cases of hilar CCAs with mucinous component (defined by the presence of mucinous component accounting for 5-50% of total tumor volume) and their conventional counterparts. 35 Unlike gastrointestinal mucinous carcinomas, mucinous iCCAs are usually microsatellite-stable. 3 However, data of mismatch-repair and microsatellite status of mucinous iCCAs was limited and controversial.…”