Value of Multidetector‐row Computed Tomography in Diagnosis of Portal Vein Invasion by Perihilar Cholangiocarcinoma

Sugiura, Teiichi; Nishio, Hisahide; Nagino, Masato; Senda, Yoshiki; Yokoyama, Yukihiro; Igami, Tsuyoshi; Oda, Koji; Nimura, Yuji

doi:10.1007/s00268-008-9547-3

Cited by 59 publications

(42 citation statements)

References 36 publications

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“…In the last 20 years, surgical management of HC has evolved due to improvements in preoperative imaging and an enhanced appreciation of tumor growth characteristics. For example, multidetector-row CT has made it possible to accurately diagnose the extent of cancer [7]. Portal vein embolization has certainly increased the safety of extended hepatectomy [8,] and has resulted in the recognition that liver resection is necessary to manage both direct hepatic invasion and the longitudinal intraductal extension that typically characterize HC [4,9,10].…”

Section: Discussionmentioning

confidence: 99%

Analysis of the Surgical Outcome and Prognostic Factors for Hilar Cholangiocarcinoma: A Chinese Experience

Qin

Cui

et al. 2011

Dig Surg

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Purposes: Hilar cholangiocarcinoma (HC) is the most common location for bile duct cancer. It represents a significant technical challenge for surgical operation due to the close proximity to major vascular structures and to the liver and arborization of the right and left biliary tree. The objective of this study was to assess the therapeutic strategies and prognostic factors that could influence the clinical outcome of HC. Methods: From January 1990 to December 2009, a total of 215 HC patients undergoing resection were included in this study. Survival and follow-up were calculated from the date of initial histologic diagnosis to the dates of first recurrence or death and last contact, respectively. Uni- and multivariate analyses were performed to examine factors affecting clinical outcome and recurrence. Results: 215 patients underwent resection: 141 (65.6%) had an R0 resection (negative histologic margins), 46 (21.4%) had an R1 resection (positive histologic margins), 28 (13.0%) had an R2 resection. The 1-, 3- and 5-year cumulative survival rates (%) of the patients were 60.3, 37.2 and 29.7%. The median survival time after R0 resection was 47.1 months, 17.2 months after R1 resection, and 12.1 months after R2 resection. The results from univariate analyses suggest that poor histopathological grade (p = 0.004), lymph node metastasis (p = 0.000), vascular invasion (p = 0.005), neuroinvasion (p = 0.044), R1 resection (p = 0.000) and T2 or T3 stage (p = 0.009) were significant predictors for poor survival rates. By multivariate analysis, only the lymph node metastasis (RR = 2.450, 95% CI 1.677–3.579) and R1 resection (RR = 0.283, 95% CI 0.183–0.437) were significantly associated with poor survival rates. Conclusions: Negative histologic margins were associated with improved outcome after all HC resections. Complete resection remains the only therapy that offers the possibility of long-term survival, and hepatic resection is a critical component of the surgical approach.

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Section: Discussionmentioning

confidence: 99%

Analysis of the Surgical Outcome and Prognostic Factors for Hilar Cholangiocarcinoma: A Chinese Experience

Qin

Cui

et al. 2011

Dig Surg

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“…26,27 After 2003, multidetector-row computed tomography (MDCT) was used for this purpose; multiplanar reformation and 3-dimensional volume-rendered (3DVR) images were generated from arterial and portal phase data and viewed from several angles as reported previously. 28 Presence or absence of vascular invasion was estimated using multiplanar reformation images, and vascular resection with reconstruction was planned using 3DVR images (Fig. 1).…”

Section: Patientsmentioning

confidence: 99%

Hepatectomy With Simultaneous Resection of the Portal Vein and Hepatic Artery for Advanced Perihilar Cholangiocarcinoma

Nagino¹,

Nimura²,

Nishio³

et al. 2010

Annals of Surgery

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279

290

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“…[20][21][22][23][24][25] Similarly, MRCP in combination with MRI is a reliable non-invasive diagnostic method for the pre-therapeutic staging of CCA. Due to its intrinsic high tissue contrast and multiplanar ability, MRI with MRCP is capable of examining all the structures involved, such as bile ducts, vessels and hepatic parenchyma, and a precise preoperative assessment of the tumour can therefore be achieved.…”

Section: Diagnosismentioning

confidence: 99%

A review of the clinical diagnosis and therapy of cholangiocarcinoma

2013

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Cholangiocarcinoma (CCA) is the second most common primary hepatic malignancy worldwide. The incidence of intrahepatic CCA is increasing, whereas that of extrahepatic CCA is decreasing. This review looks at the new advances that have been made in the management of CCA, based on a PubMed and Science Citation Index search of results from randomized controlled trials, reviews, and cohort, prospective and retrospective studies. Aggressive interventional approaches and new histopathological techniques have been developed to make a histological diagnosis in patients with high risk factors or suspected CCA. Resectability of the tumour can now be assessed using multiple radiological imaging studies; the main prognostic factor after surgery is a histologically negative resection margin. Biliary drainage and/or portal vein embolization may be performed before extended radical resection, or liver transplantation may be undertaken in combination with neoadjuvant chemotherapy or chemoradiotherapy. Though many advances have been made in the management of CCA, the standard modality of treatment has not yet been established. This review focuses on the clinical options for different stages of CCA.

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Value of Multidetector‐row Computed Tomography in Diagnosis of Portal Vein Invasion by Perihilar Cholangiocarcinoma

Abstract: MDCT is useful in assessing cancer invasion of the portal vein bifurcation by perihilar cholangiocarcinoma.

Cited by 59 publications

References 36 publications

Analysis of the Surgical Outcome and Prognostic Factors for Hilar Cholangiocarcinoma: A Chinese Experience

Analysis of the Surgical Outcome and Prognostic Factors for Hilar Cholangiocarcinoma: A Chinese Experience

Hepatectomy With Simultaneous Resection of the Portal Vein and Hepatic Artery for Advanced Perihilar Cholangiocarcinoma

A review of the clinical diagnosis and therapy of cholangiocarcinoma

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