Top

Published in:

01-07-2008 | Hepatic and Pancreatic Tumors

Intrahepatic Cholangiocarcinoma and Combined Hepatocellular-Cholangiocarcinoma: A Western Experience

Authors: Nazario Portolani, MD, Gian Luca Baiocchi, MD, Arianna Coniglio, MD, Tullio Piardi, MD, Luigi Grazioli, MD, Anna Benetti, MD, Andrea Ferrari Bravo, MD, Stefano Maria Giulini, MD

Published in: Annals of Surgical Oncology | Issue 7/2008

Abstract

Background

Intrahepatic cholangiocarcinoma (ICC) is an unusual tumour.

Methods

The clinicopathological data of 67 patients with ICC and combined hepatocellular–cholangiocarcinoma (HCC–ICC) are presented.

Results

HCV–HBV infection was present in 37.3% and chronic liver disease in 38.7% of cases, a rate higher than in the normal population; in these patients the cancer was small, often asymptomatic and of combined type. Liver resection was performed in 51 patients; at 1, 3 and 5 years, overall survival was 87.9%, 59.0%, and disease-free survival was 47.7% and 78.8%, 51.4%, and 46.7%, respectively. The better results were in the group of cirrhotic patients in whom ICC was diagnosed by a screening program for HCC (5-year survival 76.6%). Nodal metastasis showed negative prognostic value for both overall and disease-free survival; in N+ patients mean survival was 14.7 months after liver resection and lymph node dissection.

Conclusion

Viral infection and cirrhosis may be considered risk conditions for ICC and combined HCC–ICC; in resected patients survival was good. Nodal metastases must not be considered a contraindication for liver resection.

Ohtsuka M, Ito H, Kimura F, et al. Results of surgical treatment for intrahepatic cholangiocarcinoma and clinicopathological factors influencing survival. Br J Surg 2002; 89:1525–31PubMedCrossRef

Okuda K, Nakanuma Y, Miyazaki M. Cholangiocarcinoma: Recent progress. Part 1: Epidemiology and etiology. J Gastroenterol Hepatol 2002; 17:1049–55PubMedCrossRef

Weber SM, Jarnagin WR, Klimstra D, et al. Intrahepatic cholangiocarcinoma: resectability, recurrence pattern, and outcomes. J Am Coll Surg 2001; 193:134–41CrossRef

Huang JL, Biehl TR, Lee FT, et al. Outcomes after resection of cholangiocellular carcinoma. Am J Surg 2004; 87:612–7CrossRef

Kim H, Park C, Han KH, et al. Primary liver carcinoma of intermediate (hepatocyte-cholangiocyte) phenotype. J Hepatol 2004; 40:298–304PubMedCrossRef

Nakamura S, Suzuki S, Sakaguchi T, et al. Surgical treatment of patients with mixed hepatocellular carcinoma and cholangiocarcinoma. Cancer 1996; 78:1671–6PubMedCrossRef

Ng IO, Shek TW, Nicholls J, et al. Combined hepatocellular-cholangiocarcinoma: a clinicopathological study. J Gastroenterol Hepatol 1998; 13:34–40PubMedCrossRef

Taguchi J, Nakashima O, Tanaka M, et al. A clinicopathological study on combined hepatocellular and cholangiocarcinoma. J Gastroenterol Hepatol 1996; 11:758–64PubMedCrossRef

Jarnagin WR, Weber S, Tickoo SK, et al. Combined hepatocellular and cholangiocarcinoma: demographic, clinical, and prognostic factors. Cancer 2002; 94:2040–6PubMedCrossRef

10.

Cazals-Hatem D, Rebouissou S, Bioulac-Sage P, et al. Clinical and molecular analysis of combined hepatocellular-cholangiocarcinomas. J Hepatol 2004; 41:292–8PubMedCrossRef

11.

Green FL (ed.) AJCC cancer staging manual, 6th edn. New York: Springer Verlag, 2002

12.

Liver cancer study group of Japan. Classification of primary liver cancer, 1st edn. Tokyo: Kanahara, 1997

13.

Goodman ZD, Ishak KG, Langloss JM, et al. Combined hepatocellular-cholangiocarcinoma. A histologic and immunohistochemical study. Cancer 1985; 55:124–35PubMedCrossRef

14.

Kojiro M. Patomorphology of advanced hepatocellular carcinoma. In: Tobe K, Kameda H, Okudaira M, et al. (eds) Primary liver cancer in Japan. Tokyo: Springer-Verlag 1992, pp 31–37

15.

Nagafuchi Y, Okamoto K, Shono M, et al. Separate histogenesis of combined hepatocellular and cholangiocellular carcinoma in two patients. Hepatogastroenterology 1998; 45:523–7PubMed

16.

Liu CL, Fan ST, Lo CM, et al. Hepatic resection for combined hepatocellular and cholangiocarcinoma. Arch Surg 2003; 138:86–90PubMedCrossRef

17.

Koh KC, Lee H, Choi MS, et al. Clinicopathological features and prognosis of combined hepatocellular cholangiocarcinoma. Am J Surg 2005; 189:120–5PubMedCrossRef

18.

Yano Y, Yamamoto J, Kosuge T, et al. Combined hepatocellular and cholangiocarcinoma: a clinicopathologic study of 26 resected cases. Jpn J Clin Oncol 2003; 33:283–7PubMedCrossRef

19.

Portolani N, Coniglio A, Ghidoni S, et al. Early and late recurrence after liver resection for hepatocellular carcinoma (HCC). Prognostic and therapeutic implications. Ann Surg 2006; 243:229–35PubMedCrossRef

20.

Chiesa R, Donato F, Portolani N, et al. Primary liver cancer in a high incidence area in north Italy: ethiological hypotheses arising from routinely collected data. Eur J Epidem 1995; 6:435–42CrossRef

21.

Donato F, Tagger A, Gelatti U, et al. Alcohol and hepatocellular carcinoma : the effect of lifetime intake and hepatitis virus infections in men and women. Am J Epidemiol 2002; 155:323–31PubMedCrossRef

22.

Kobayashi M, Ikeda K, Saitoh S, et al. Incidence of primary cholangiocellular carcinoma of the liver in Japanese patients with hepatitis C virus-related cirrhosis. Cancer 2000; 88:2471–7PubMedCrossRef

23.

Han SL, Zhu GB, Yao JG, et al. Diagnosis and surgical treatment of primary hepatic cholangiocarcinoma. Hepatogastroenterology 2005; 52:348–51PubMed

24.

Shimoda M, Farmer DG, Colquhoun SD, et al. Liver transplantation for cholangiocellular carcinoma: analysis of single-center experience and review of the literature. Liver Transplantation 2001; 7:1023–33PubMedCrossRef

25.

Valverde A, Bonhomme N, Farges O, et al. Resection of intrahepatic cholangiocarcinoma: a Western experience. J Hepatobiliary Pancreat Surg 1999; 6:122–7PubMedCrossRef

26.

Kaczynski J, Hansson G, Wallersted S. Incidence, etiologic aspects and clinicophatologic features in intrahepatic cholangiocellular carcinoma: a study of 51 cases from a low-endemicity area. Acta Oncol 1998; 37:77–83PubMedCrossRef

27.

Roayaie S, Guarrera J, Ye MQ, et al. Aggressive surgical treatment of intrahepatic cholangiocarcinoma: predictors of outcomes. J Am Coll Surg 1998; 187:365–72PubMedCrossRef

28.

Sasaki A, Aramaki M, Kawano K, et al. Intrahepatic peripheral cholangiocarcinoma: mode of spread and choice of surgical treatment. Br J Surg 1998; 85:1206–9PubMedCrossRef

29.

Nakeeb A, Pitt HA, Sohn TA, et al. Cholangiocarcinoma. A spectrum of intrahepatic, perihilar, and distal tumors. Ann Surg 1996; 224:463–75PubMedCrossRef

30.

Nozaki Y, Yamamoto M, Ikai I, et al. Reconsideration of the lymph node metastasis pattern (N factor) from intrahepatic cholangiocarcinoma using the international union against cancer TNM staging system for primary liver carcinoma. Cancer 2001; 83:1923–9CrossRef

31.

Isa T, Kusano T, Shimoji H, et al. Predictive factors for long-term survival in patients with intrahepatic cholangiocarcinoma. Am J Surg 2001; 181:507–11PubMedCrossRef

32.

Inoue M, Makuuchi T, Takayama, et al. Long-term survival and prognostic factors in the surgical treatment of mass-forming type cholangiocarcinoma. Surgery 2000; 127:498–505PubMedCrossRef

33.

Grobmyer SR, Wang L, Gonen M, et al. Perihepatic lymph node assessment in patients undergoing partial hepatectomy for malignancy. Ann Surg 2006; 244:260–4PubMedCrossRef

34.

Akatsu T, Shimazu M, Kawachi S, et al. Long-term survival of intrahepatic cholangiocarcinoma with hilar lymph node metastasis and portal vein involvement. Hepatogastroenterology 2005; 52:603–5PubMed

35.

Lang H, Sotiropulos GC, Fruhauf NR, et al. Extended hepatectomy for intrahepatic cholangiocellular carcinoma (ICC). Ann Surg 2005; 241:134–43PubMed

36.

Puhalla H, Schuell B, Pokorny H, et al. Treatment and outcome of intrahepatic cholangiocellular carcinoma. Am J Surg 2005; 189:173–7PubMedCrossRef

37.

Slakey DP. Radiofequency ablation of recurrent cholangiocarcinoma. Am Surg 2002; 68:395–7PubMed

38.

Shirabe K, Shimada M, Tsujita E. Prognostic factors in node-negative intrahepatic cholangiocarcinoma with special reference to angiogenesis. Am J Surg 2004; 187:538–42PubMedCrossRef

Title: Intrahepatic Cholangiocarcinoma and Combined Hepatocellular-Cholangiocarcinoma: A Western Experience
Authors: Nazario Portolani, MD
Gian Luca Baiocchi, MD
Arianna Coniglio, MD
Tullio Piardi, MD
Luigi Grazioli, MD
Anna Benetti, MD
Andrea Ferrari Bravo, MD
Stefano Maria Giulini, MD
Publication date: 01-07-2008
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 7/2008
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-008-9933-y

At a glance: The STEP trials

Springer Medicine

Intrahepatic Cholangiocarcinoma and Combined Hepatocellular-Cholangiocarcinoma: A Western Experience

Abstract

Background

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 7/2008

Radical Resection After IORT-Containing Multimodality Treatment is the Most Important Determinant for Outcome in Patients Treated for Locally Recurrent Rectal Cancer

Cancer Clinical Trials Accrual: Missed Opportunities to Address Disparities and Missed Opportunities to Improve Outcomes for All

Perioperative Use of β-blockers and COX-2 Inhibitors May Improve Immune Competence and Reduce the Risk of Tumor Metastasis

Tumor Diameter as a Prognostic Factor in Patients with Gastric Cancer

Angiography is Indicated for Every Sentinel Bleed after Pancreaticoduodenectomy

Certificate of Need Regulations and the Availability and Use of Cancer Resections