Surgical outcomes of hepatocellular carcinoma with bile duct tumor thrombus: A Korea-Japan multicenter study

Kim, D.S.; Kaibori, Masaki; Kon, Masanori; Yamamoto, Masakazu; Wang, H.J.

doi:10.1016/j.hpb.2018.06.049

Cited by 21 publications

(29 citation statements)

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“…Thus far, several studies have explored the component and features about HCC with BDTT [5,8,17]. Many surgeons reached a consensus that hepatectomy for HCC with HBDTT is necessary [10,11,43,44]. In comparison, bile duct resection in patients with HCC and HBDTT remains controversial.…”

Section: Discussionmentioning

confidence: 99%

“…Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer, comprising 75 to 85% of cases [1], but HCC with bile duct tumor thrombus (BDTT) is uncommon with incidence between 0.53 to 12.9% [2][3][4][5][6]. Previous studies have attempted to explore the clinical, pathological, imaging features as well as treatment and prognosis of HCC with BDTT [7][8][9][10][11][12][13]. Both CT and MRI have diagnostic value for HCC with BDTT and can evaluate the extension of tumor thrombus.…”

Section: Introductionmentioning

confidence: 99%

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Hepatocellular carcinoma with hilar bile duct tumor thrombus versus hilar Cholangiocarcinoma on enhanced computed tomography: a diagnostic challenge

et al. 2020

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Background: Hepatocellular carcinoma (HCC) with hilar bile duct tumor thrombus (HBDTT) often mimic hilar cholangiocarcinoma (hilar CC). The purpose of this study is to analyze the Computed Tomography (CT) characteristics of HCC with HBDTT and to identify imaging features to aid its differentiation from hilar CC on enhanced CT. Methods: We retrospectively identified 58 cases with pathologically proved HCC with HBDTT between 2011 and 2018. Seventy-seven cases of pathologically proven hilar CCs were selected during the same period. The clinical features and CT findings of the two groups were reviewed and compared. Results: HCC with HBDTTs are more commonly found in men (87.9% vs 63.6%, p = 0.001) with lower age of onset (49.84 vs 58.61 years; p < 0.001) in comparison to hilar CCs. Positive correlation were identified between HCC with HBDTTs and chronic HBV infection (72.4% vs 11.7%; p < 0.001), increased serum AFP (67.2% vs 1.3%; p < 0.001), CA19-9 level (58.6% vs 85.7%; p < 0.001) and CEA level (3.4% vs 29.9%; p = 0.001), parenchymal lesion with intraductal lesion (100% vs 18.2%; p < 0.001), washout during the portal venous phase (84.5% vs 6.5%; p < 0.001), thickened bile duct wall (8.6% vs 93.5%; p < 0.001), intrahepatic vascular embolus (44.8% vs 7.8%; p < 0.001), splenomegaly (34.5% vs 2.6%, p < 0.001). A scoring system consisting of the five parameters obtained from characteristics mentioned above was trialed. The sensitivity and specificity for diagnosing HCC with HBDTT were 96.39, 100 and 92.5% respectively when the total score was 2 or more. Conclusions: HCC with HBDTTs are often distinguishable from hilar CCs based on washout during portal venous phase without thickened bile duct wall. HBV infection and serum AFP level facilitate the differentiation.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Hepatocellular carcinoma with hilar bile duct tumor thrombus versus hilar Cholangiocarcinoma on enhanced computed tomography: a diagnostic challenge

et al. 2020

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“…According to a recent report, 46.7% of HCC patients with TT in the right or left hepatic duct or the common hepatic bile duct presented with jaundice. Biliary drainage was performed in 83.3% of patients with jaundice and concurrent hemobilia was observed in 26 of 120 (22%) patients with jaundice [6].…”

Section: Discussionmentioning

confidence: 99%

“…Obstructive jaundice due to tumor thrombus (TT) in the common bile duct with hepatocellular carcinoma (HCC) is classified as icteric-type HCC [1]. Icteric-type HCC is considered a fatal condition; however, if curative surgery is achieved, long-term survival can be expected [[1], [2], [3], [4], [5], [6], [7]]. Biliary drainage is mandatory in icteric-type HCC patients who undergo major hepatectomy for the precise evaluation of liver function and prevention of cholangitis.…”

Section: Introductionmentioning

confidence: 99%

A staged approach with initial tumor thrombectomy followed by hepatectomy for icteric-type hepatocellular carcinoma: A case report

Yazawa

Ohta

Ariizumi

et al. 2019

International Journal of Surgery Case Reports

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“…Previous studies have attempted to explore the clinicopathological characteristics and surgical treatment of HCC with BDTT [6][7][8][9][10]. Hepatectomy have generally been considered the preferred treatment for HCC with BDTT.…”

Section: Introductionmentioning

confidence: 99%

Imaging Features of Hepatocellular Carcinoma with Bile Duct Tumor Thrombus: A Multicenter Study

Huang¹,

Wu²,

Bai³

et al. 2020

Preprint

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Abstract Background: There are still difficult and challenging problems in diagnosis of hepatocellular carcinoma (HCC) with bile duct tumor thrombus (BDTT) before operation. This study aimed to analyze the imaging features of HCC with B1-B3 BDTT. Methods: The clinicopathological data and imaging findings of 30 HCC patients with B1-B3 BDTT from three high-volume institutions were retrospectively reviewed. Eighteen patients underwent computed tomography (CT) scans and twelve patients underwent magnetic resonance imaging (MRI) scans before operation, respectively. The diagnosis of HCC with BDTT was conﬁrmed by postoperative pathologic examination.Results: According to Japanese classification, 5 patients were classified as B1 BDTT, 12 B2, 13 B3, and 82 B4, respectively. The HCC lesions were detected in all patients, and the localized bile duct dilation were detected in 28 (93.3%) patients. The BDTT was observed in all B3 patients and 3 B2 patients, but it was not observed in all B1 patients on CT or MRI. The BDTT showed relatively hypoattenuation on plain CT scans and T1W images, relatively hyperattenuation signals on T2W. The BDTT showed hyperattenuation at hepatic arterial phase with washout at portal venous phase. The localized biliary dilation showed no enhancement at hepatic arterial phase and no progressively delayed enhancement at portal venous phase, but it was more obvious at portal venous phase on CT.Conclusions: The HCC lesions and the localized bile duct dilatation on CT or MRI scans are imaging features of HCC with BDTT, which might facilitate the early diagnosis for B1-B3 BDTT.

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Surgical outcomes of hepatocellular carcinoma with bile duct tumor thrombus: A Korea-Japan multicenter study

Cited by 21 publications

References 0 publications

Hepatocellular carcinoma with hilar bile duct tumor thrombus versus hilar Cholangiocarcinoma on enhanced computed tomography: a diagnostic challenge

Hepatocellular carcinoma with hilar bile duct tumor thrombus versus hilar Cholangiocarcinoma on enhanced computed tomography: a diagnostic challenge

A staged approach with initial tumor thrombectomy followed by hepatectomy for icteric-type hepatocellular carcinoma: A case report

Imaging Features of Hepatocellular Carcinoma with Bile Duct Tumor Thrombus: A Multicenter Study

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