Recurrence after Curative Resection for Intrahepatic Cholangiocarcinoma: How to Predict the Chance of Repeat Hepatectomy?

Langella, Serena; Russolillo, Nadia; Ossola, Paolo; Luzzi, Andrea-Pierre; Casella, Michele; Tesoriere, Roberto Lo; Ferrero, Alessandro

doi:10.3390/jcm10132820

Cited by 12 publications

(4 citation statements)

References 37 publications

(59 reference statements)

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“…In the patient population included in our study, 17.7% (30/169) of BTC patients underwent a second surgery (R0 = 14, R1 = 6, R2 = 3, exploratory laparotomy = 7); interestingly, no recurrences were observed in the 14 BTC patients treated with R0 surgery. In recent years, a growing number of studies have evaluated the role of repeated resections in BTC, especially in iCCA patients, with some of these reports suggesting the potential survival benefit of this surgical approach [ 22 , 23 ]. Our findings are consistent with these studies, highlighting that repeated surgical resection can be performed in selected BTC patients.…”

Section: Discussionmentioning

confidence: 99%

Intensive Follow-Up Program and Oncological Outcomes of Biliary Tract Cancer Patients after Curative-Intent Surgery: A Twenty-Year Experience in a Single Tertiary Medical Center

et al. 2022

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Aim. The aim of this research was to assess the impact of an intensive follow-up program on BTC patients who had received surgery with curative intent at a tertiary referral hospital. Methods. BTC patients were followed-up every three months during the first two years after their first surgery and every six months from the third to the fifth post-operative year. Results. A total of 278 BTC patients who received R0/R1 surgery were included. A total of 17.7% of patients underwent a second surgery following disease relapse, and none of these patients experienced additional disease relapse. Conclusions. An intensive follow-up after surgical resection may help in the early identification of disease relapse, leading to early treatment and prolonged survival in selected cases.

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Section: Discussionmentioning

confidence: 99%

Intensive Follow-Up Program and Oncological Outcomes of Biliary Tract Cancer Patients after Curative-Intent Surgery: A Twenty-Year Experience in a Single Tertiary Medical Center

et al. 2022

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“…In a large German series of 202 patients with resected iCCA, 60.9% had a recurrence at a median of 7.5 months after resection, and 44% recurred in the liver only (123). In another Italian series of the 140 patients who underwent surgery for iCCA, 58.2% of the patients who recurred had liver metastasis (124). While hepatic recurrence is also common in hilar and distal cholangiocarcinoma, repeat resection is rarely possible (125).…”

Section: Cholangiocarcinomamentioning

confidence: 99%

“…Several studies have attempted to understand the factors that influence the benefit of a repeat resection. In one study, tumor biology (disease-free interval of ≤12 months) and extent of initial liver resection (major hepatectomy) decreased the likelihood that repeat liver resection would results in a long-term benefit (124). Margin status, CA 19-9 at time of primary resection, and time to recurrence have been identified as other important predictors of long-term outcome (133).…”

Section: Repeat Hepatectomymentioning

confidence: 99%

Liver-Directed Treatment Options Following Liver Tumor Recurrence: A Review of the Literature

2022

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Recurrence following curative-intent hepatectomy for colorectal cancer liver metastasis, hepatocellular carcinoma, or cholangiocarcinoma is unfortunately common with a reported incidence as high as 75%. Various treatment modalities can improve survival following disease recurrence. A review of the literature was performed using PubMed. In addition to systemic therapy, liver-directed treatment options for recurrent liver disease include repeat hepatectomy, salvage liver transplantation, radiofrequency or microwave ablation, intra-arterial therapy, and stereotactic body radiation therapy. Repeat resection can be consider for patients with limited recurrent disease that meets resection criteria, as this therapeutic approach can provide a survival benefit and is potentially curative in a subset of patients. Salvage liver transplantation for recurrent hepatocellular carcinoma is another option, which has been associated with a 5-year survival of 50%. Salvage transplantation may be an option in particular for patients who are not candidates for resection due to underlying liver dysfunction but meet criteria for transplantation. Ablation is another modality to treat patients who recur with smaller tumors and are not surgical candidates due to comorbidity, liver dysfunction, or tumor location. For patients with inoperable disease, transarterial chemoembolization, or radioembolization with Yttrium-90 are liver-directed intra-arterial therapy modalities with relatively low risks that can be utilized. Stereotactic body radiation therapy is another palliative treatment option that can provide a response and local tumor control for smaller tumors.

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“…High rates of recurrence and metastasis following resection are the leading causes of poor prognosis. In fact, recurrence is estimated to occur in 45% to 70% of patients with ICC (7)(8)(9)(10).…”

Section: Introductionmentioning

confidence: 99%

Radiomics Analysis of Contrast-Enhanced CT for the Preoperative Prediction of Microvascular Invasion in Mass-Forming Intrahepatic Cholangiocarcinoma

et al. 2021

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BackgroundMicrovascular invasion (MVI) has been shown to be closely associated with postoperative recurrence and metastasis in patients with intrahepatic cholangiocarcinoma (ICC). We aimed to develop a radiomics prediction model based on contrast-enhanced CT (CECT) to distinguish MVI in patients with mass-forming ICC.Methods157 patients were included and randomly divided into training (n=110) and test (n=47) datasets. Radiomic signatures were built based on the recursive feature elimination support vector machine (Rfe-SVM) algorithm. Significant clinical-radiologic factors were screened, and a clinical model was built by multivariate logistic regression. A nomogram was developed by integrating radiomics signature and the significant clinical risk factors.ResultsThe portal phase image radiomics signature with 6 features was constructed and provided an area under the receiver operating characteristic curve (AUC) of 0.804 in the training and 0.769 in the test datasets. Three significant predictors, including satellite nodules (odds ratio [OR]=13.73), arterial hypo-enhancement (OR=4.31), and tumor contour (OR=4.99), were identified by multivariate analysis. The clinical model using these predictors exhibited an AUC of 0.822 in the training and 0.756 in the test datasets. The nomogram combining significant clinical factors and radiomics signature achieved satisfactory prediction efficacy, showing an AUC of 0.886 in the training and 0.80 in the test datasets.ConclusionsBoth CECT radiomics analysis and radiologic factors have the potential for MVI prediction in mass-forming ICC patients. The nomogram can further improve the prediction efficacy.

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Recurrence after Curative Resection for Intrahepatic Cholangiocarcinoma: How to Predict the Chance of Repeat Hepatectomy?

Cited by 12 publications

References 37 publications

Intensive Follow-Up Program and Oncological Outcomes of Biliary Tract Cancer Patients after Curative-Intent Surgery: A Twenty-Year Experience in a Single Tertiary Medical Center

Intensive Follow-Up Program and Oncological Outcomes of Biliary Tract Cancer Patients after Curative-Intent Surgery: A Twenty-Year Experience in a Single Tertiary Medical Center

Liver-Directed Treatment Options Following Liver Tumor Recurrence: A Review of the Literature

Radiomics Analysis of Contrast-Enhanced CT for the Preoperative Prediction of Microvascular Invasion in Mass-Forming Intrahepatic Cholangiocarcinoma

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