The 8th Edition American Joint Committee on Cancer Staging for Hepato-pancreato-biliary Cancer: A Review and Update

Liao, Xiaoyan; Zhang, Dongwei

doi:10.5858/arpa.2020-0032-ra

Cited by 55 publications

(39 citation statements)

References 70 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Rupture of hepatocellular carcinoma is considered a severe complication ( 8 – 11 ), and once it occurs, the prognosis may be less than optimal even with corresponding treatment. At the same time, ruptured HCC was directly classified into T4 according to the latest TNM system ( 12 ). However, in practical clinical work, if rHCC patients are treated aggressively, a relatively good result can also be achieved, and we believe it is not appropriate to classify ruptured HCC patients directly into T4.…”

Section: Discussionmentioning

confidence: 99%

Early-Stage Ruptured Hepatocellular Carcinoma With Different Tumor Diameters: Small Tumors Have a Better Prognosis

et al. 2022

View full text Add to dashboard Cite

Background and AimRuptured hepatocellular carcinoma (rHCC) is classified as T4 according to the TNM staging system with a very poor (does not achieve expected) prognosis, which has always been controversial. This study aimed at assessing the specific impact of different tumor diameters on the posttreatment prognosis of BCLC stage 0/A rHCC patients.MethodsData from 258 patients with BCLC stage 0/A HCC treated in our center from January 2008 to December 2017 were collected, including 143 rHCC patients and 115 patients with non-ruptured HCC (nrHCC). With the help of X-tile software, we determined the cutoff value of the tumor diameter in patients with rHCC. Using 8 cm as the cutoff, we divided rHCC patients into Small-rHCC (n = 96) and Large-rHCC (n = 47) groups, compared the prognoses of the S-rHCC and L-rHCC groups, as well as the prognoses of the two groups with the nrHCC group using the Kaplan–Meier method, and screened the prognostic factors of rHCC patients using the multivariate Cox risk model.ResultsThe OS of the S-rHCC group was significantly higher than that of the L-rHCC group [HR = 2.41 (1.60–3.63)], and the OS of the nrHCC group was comparable to that of the S-rHCC group (P = 0.204). In patients treated with surgery only, OS and RFS were also comparable in the S-rHCC nrHCC group. Meanwhile, multivariate Cox regression analysis revealed that alpha-fetoprotein (AFP), alkaline phosphatase (ALP), and the main method of treatment were also prognostic factors for OS in patients with rHCC.ConclusionsRuptured HCC with a relatively small diameter (≤8 cm) can also achieve the same prognosis as nrHCC patients after aggressive treatment. It is also not recommended to include all patients with rHCC in stage T4.

show abstract

Section: Discussionmentioning

confidence: 99%

Early-Stage Ruptured Hepatocellular Carcinoma With Different Tumor Diameters: Small Tumors Have a Better Prognosis

et al. 2022

View full text Add to dashboard Cite

show abstract

“…13,18,19 The American Joint Committee on Cancer (AJCC) 8th edition of TNM staging classified CHC and ICC into one category and shared the ICC-specific staging system. 20 The AJCC staging systems have been revised several times; however, until recently, the CHC did not own specific protocol. Tian et al 21 answer in the current large population-based study was "No."…”

Section: Discussionmentioning

confidence: 99%

Survival outcomes of combined hepatocellular‐cholangiocarcinoma compared with intrahepatic cholangiocarcinoma: A SEER population‐based cohort study

Yang

Shi

2021

Cancer Medicine

View full text Add to dashboard Cite

Background: Combined hepatocellular-cholangiocarcinoma (CHC) is a heterogeneous group of primary liver cancers characterized by the coexistence of both hepatic and biliary cellular contents. The aim of this study was to compare CHC and intrahepatic cholangiocarcinoma (ICC) and investigate the treatment and survival of patients with CHC.Methods: Data on CHC and ICC, including clinicopathological characteristics, treatments, and survival outcomes were extracted from the SEER database between 2004 and 2016. Univariate and multivariate analyses of all data were performed to identify the risk factors associated with survival outcomes. The overall survival (OS) rates of CHC patients who underwent hepatic resection (HR) or liver transplantation (LT) were also assessed before and after propensity score matching.Results: A total of 1066 consecutive patients who had been diagnosed with CHC (n = 286) or ICC (n = 780) were identified. The mean age of the CHC cohort was 60.8±10.7 years old. Among the CHC group, a large proportion of the patients were men and of White ethnicity (73.1% and 71.3%, respectively). The majority of tumors were poorly differentiated (37.8%), while the most common AJCC stage at presentation was stage I (31.4%). Multivariable analysis of all CHC patients revealed that only tumor size, M 1 stage, AJCC stage IIIC, AJCC stage IV, surgery, and chemotherapy were significantly associated with OS. The OS was comparable with the ICC in the initial 36 months and better in the subsequent follow-up after treatment. Surgery was associated with better survival outcomes, whether in the early or advanced stages. Regarding the specific types of surgery, the OS rates were similar in selected patients following HR or LT. Conclusion:In patients with CHC, surgical intervention resulted in better longterm survival outcomes than nonsurgical treatments. The OS rate of CHC patients compared with that of ICC patients was discriminated before and after a 3-year follow-up.

show abstract

“…Patients who were preoperatively diagnosed with ICC underwent hepatectomy with regional LN dissection, whereas patients who were diagnosed with hepatocellular carcinoma (HCC) or metastatic liver tumors underwent hepatectomy without regional LN dissection. Pathologic staging was evaluated according to the sixth edition of the Liver Cancer Study Group of Japan (LCSGJ) and the eighth edition of the American Joint Committee on Cancer (AJCC) guidelines (Liao and Zhang, 2020). Postoperative complications were evaluated by Clavien-Dindo score (Dindo et al, 2004).…”

Section: Patientsmentioning

confidence: 99%

Investigation of a Tumor Location-Specific Therapeutic Strategy for Intrahepatic Cholangiocarcinoma

Kosaka

Kaibori

Matsui

et al. 2021

Asian Pac J Cancer Prev

View full text Add to dashboard Cite

Objective: An optimal therapeutic strategy for intrahepatic cholangiocarcinoma (ICC) has not yet been determined. Herein we focused on intrahepatic tumor location and retrospectively analyzed tumor characteristics depending on location to elucidate a location-specific therapeutic strategy for ICC. Methods: Sixty-five ICC patients were divided into three groups based on the distance between the innermost portion of the tumor and portal vein branches observed on preoperative imaging: peripheral, intermediate and central ICC. Results: Median disease-specific survival (DSS) of the peripheral ICC was not reached, whereas median DSS was 32.9 months in intermediate ICC and 25.2 months in central ICC (p <0.05). Vascular invasion was observed in all groups (56-92%). Bile duct invasion to the first branch of the hepatic duct was more commonly observed in central ICC (43%) compared with the peripheral and intermediate ICC (0-8%). Lymph node metastasis was not observed in peripheral ICC, whereas it was frequently observed in intermediate and central ICC (39-44%). A Cox regression analysis revealed sufficient RDI (≥58.3%) of adjuvant chemotherapy (AC) significantly increased the length of DSS (HR: 0.205). Based on these data, we have proposed a location-specific therapeutic strategy as follows: peripheral ICC requires anatomical resection without lymphadenectomy; intermediate ICC requires anatomical resection with lymphadenectomy and sufficient doses of AC; and central ICC requires anatomical resection with extrahepatic bile duct resection, caudate lobectomy, lymphadenectomy, and sufficient doses of AC. Conclusion: We propose an intrahepatic tumor location-specific therapeutic strategy for ICC. This information could contribute to the appropriate therapeutic management of patients with ICC.

show abstract

The 8th Edition American Joint Committee on Cancer Staging for Hepato-pancreato-biliary Cancer: A Review and Update

Cited by 55 publications

References 70 publications

Early-Stage Ruptured Hepatocellular Carcinoma With Different Tumor Diameters: Small Tumors Have a Better Prognosis

Early-Stage Ruptured Hepatocellular Carcinoma With Different Tumor Diameters: Small Tumors Have a Better Prognosis

Survival outcomes of combined hepatocellular‐cholangiocarcinoma compared with intrahepatic cholangiocarcinoma: A SEER population‐based cohort study

Investigation of a Tumor Location-Specific Therapeutic Strategy for Intrahepatic Cholangiocarcinoma

Contact Info

Product

Resources

About