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Prognostic factors for patients with mass-forming intrahepatic cholangiocarcinoma:A case series of 68 patients

World Journal of Gastrointestinal Surgery 2022年第5期14卷 442-451页

作者： Jian Feng Bin Liang Hang-Yu Zhang Zhe Liu Kai Jiang Xiang-Qian Zhao Department of Hepatopancreatobiliary Surgery Peking University Shougang HospitalBeijing 100144China Faculty of Hepato-Pancreato-Biliary Surgery Institute of Hepatobiliary Surgery of Chinese PLAKey Laboratory of Digital Hepatobiliary SurgeryChinese PLA General HospitalBeijing 100853China

BACKGROUND Intrahepatic cholangiocarcinoma(ICC)is the second most common primary liver cancer in humans after hepatocellular carcinoma and a rare epithelial malignancy that results in a poor *** to the Liver Cancer Study Group of Japan classification,ICC can be divided into three types:mass-forming(MF)type,periductal-infiltrating(PI)type,and intraductal-growth *** MF type is the most common,accounting for 57.1-83.6%of ***,little is known about the epidemiology and treatment of MF *** To examine the prognostic factors for patients with MF *** We carried out a retrospective analysis of consecutive patients with MF ICC treated at the Faculty of Hepato-Pancreato-Biliary Surgery of Chinese PLA General Hospital between January 2008 and December *** to the treatment received,the patients were divided into either a resection group or an exploration *** The pooled 1-,3-,and 5-year survival rates in the 68 patients with MF ICC were 66.5%,36.3%,and 9.3%,*** analysis revealed that surgical resection(P<0.001),nodal metastasis(P<0.001),tumor location(P=0.039),vascular invasion(P<0.001),ascites(P<0.001),and differentiation(P=0.009)were significantly associated with the prognosis and survival of MF *** analysis revealed that ascites(hazard ratio[HR]=5.6,95%confidence interval[CI]:1.6-18.9,P=0.006)and vascular invasion(HR=2.5,95%CI:1.0-6.1,P=0.045)were independent risk factors for MF *** pooled 1-,3-,and 5-year survival rates in the 19 patients of the exploration group were 5.3%,5.3%,and 0,*** the 49 patients who underwent surgical resection,the pooled 1-,3-,and 5-year survival rates were 93.5%,49.7%,and 14.4%,*** and multivariate analyses revealed that vascular invasion(HR=3.1,95%CI:1.2-8.5,P=0.024)and nodal metastasis(HR=3.2,95%CI:1.4-7.6,P=0.008)were independent prognostic risk factors for surgical resection *** The prognosis

关键词： Intrahepatic cholangiocarcinoma mass-forming Treatment Prognosis

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Role of routine lymph node dissection alongside resection ofintrahepatic cholangiocarcinoma: Systematic review and metaanalysis

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World Journal of Gastrointestinal Oncology 2023年第11期15卷 2017-2032页

作者： Mo Atif Aditya Borakati Vasileios K Mavroeidis Department of Colorectal Surgery University Hospitals Birmingham NHS Foundation TrustBirmingham B152GWUnited Kingdom Department of HPB and Liver Transplantation Surgery Royal Free Hospital NHS Foundation TrustLondon NW32QGUnited Kingdom Department of HPB Surgery University Hospitals Bristol and Weston NHS Foundation TrustBristol Royal InfirmaryBristol BS28HWUnited Kingdom Department of Academic Surgery Royal Marsden NHS Foundation TrustLondon SW36JJUnited Kingdom

BACKGROUND The global incidence of intrahepatic cholangiocarcinoma(ICCA)is *** to often delayed presentation,only a narrow spectrum of the disease is usually surgically *** more accurately stage the disease,reduce recurrence,and improve overall survival,surgical teams are increasingly performing intraoperative lymph node dissection(LND)as *** procedure has its associated morbidity,while there is no consensus or formal guidelines on its role in this ***,there is a need to better delineate the evidence for performing LND alongside surgical resection of the *** To perform a systematic review and meta-analysis on the role of LND in improving prognostication and survival post-resection of *** We performed a systematic literature search using Pubmed,Medline,Embase,and the Cochrane Library,for all studies involving LND,ICCA,and surgical resection using several keywords,Medical Subject Headings(MeSH)tags,and appropriate *** clinical studies comparing curative intent resection of ICCA with LND vs resection without LND were included,while single-arm case series,studies with insufficient data,and duplicates were *** included all English-language studies from the different academic databases up till early December *** primary outcome measures were set for overall survival(OS)and disease-free survival(DFS).RESULTS This systematic review and meta-analysis included 15 studies that fulfilled the selection criteria comprising 11413 patients with surgically-resectable ICCA,of whom 6424(56.3%)underwent hepatectomy with LND while the remainder underwent hepatectomy *** patients who underwent LND,on average,27.7%of the resected lymph nodes were positive for metastatic ***,the results showed that performing LND did not significantly improve OS or ***,the effect of LND on OS showed a degree of variability by geographical region,in Eastern and Western *** LND is increasingly being perform

关键词： Cholangiocarcinoma Periductal-infiltrating mass-forming Lymphadenectomy Lymph node metastasis Hepatectomy

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