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01-12-2012 | Original Article

Periductal infiltrating type of intrahepatic cholangiocarcinoma: a rare macroscopic type without any apparent mass

Authors: Masanori Uno, Kazuaki Shimada, Yusuke Yamamoto, Satoshi Nara, Minoru Esaki, Yoshihiro Sakamoto, Tomoo Kosuge, Hidenori Ojima

Published in: Surgery Today | Issue 12/2012

Abstract

Purpose

This study was undertaken to elucidate the clinicopathological characteristics and surgical outcome of the periductal infiltrating (PI) type of intrahepatic cholangiocarcinoma (ICC), which is a distinct macroscopic type of ICC arising from the second-order of the intrahepatic bile ducts without apparent invasion of the surrounding liver parenchyma.

Methods

All patients with the PI type of ICC were identified from a database of patients with intrahepatic cholangiocellular carcinoma that underwent surgical resection between 1983 and 2009. The clinicopathological data of these patients were analyzed retrospectively.

Results

Sixteen of 203 patients (7.9%) had the PI type of ICC. The median survival was 7.7 years with 5-year survival rate of 62.1%. The PI type of ICC showed a significantly better survival than the mass-forming (MF) type (P = 0.0293) or MF plus PI type of ICC (P = 0.0001). Microscopic examinations showed intrahepatic metastasis to be absent in all the patients with PI type ICC. The incidence of intrahepatic metastases in patients with PI type was significantly lower in comparison to that of patients with MF type (P = 0.0030) and MF plus PI type (P = 0.0533), respectively.

Conclusion

Surgery could therefore provide a favorable outcome in patients with the PI type of ICC, probably due to its lower incidence of intrahepatic metastases.

Ikai I, Arii S, Okazaki M, Okita K, Omata M, Kojiro M, et al. Report of the 17th nationwide follow-up survey of primary liver cancer in Japan. Hepatol Res. 2007;37:676–91.PubMedCrossRef

Patel T. Increasing incidence and mortality of primary intrahepatic cholangiocarcinoma in the United States. Hepatology. 2001;33:1353–7.PubMedCrossRef

Nakajima T, Kondo Y, Miyazaki M, Okui K. A histopathologic study of 102 cases of intrahepatic cholangiocarcinoma. Histologic classification and modes of spreading. Hum Pathol. 1988;19:1228–34.PubMedCrossRef

Yamamoto M, Takasaki K, Yoshikawa T, Ueno K, Nakano M. Does gross appearance indicate prognosis in intrahepatic cholangiocarcinoma? J Surg Oncol. 1998;69:162–7.PubMedCrossRef

Yamamoto J, Kosuge T, Takayama T, Shimada K, Makuuchi M, Yoshida J, et al. Surgical treatment of intrahepatic cholangiocarcinoma: four patients surviving more than five years. Surgery. 1992;111:617–22.PubMed

Sano T, Shimada K, Sakamoto Y, Ojima H, Esaki M, Kosuge T, et al. Prognosis of perihilar cholangiocarcinoma: hilar bile duct cancer versus intrahepatic cholangiocarcinoma involving the hepatic hilus. Ann Surg Oncol. 2008;15:590–9.PubMedCrossRef

Yamasaki S. Intrahepatic cholangiocarcinoma: macroscopic type and stage classification. J Hepatobiliary Pancreat Surg. 2003;10:288–91.PubMedCrossRef

Liver Cancer Study Group of Japan General Rules for the Clinical and Pathological Study of Primary Liver Cancer, 2nd edn. Tokyo: Kanehara; 2003.

Couinaud C. Lobes et segments hepatiques [in French]. Presse Med. 1954;62:709–12.PubMed

10.

Hirohashi K, Uenishi T, Kubo S, Yamamotu T, Tanaka H, Shuto T, et al. Macroscopic types of intrahepatic cholangiocarcinoma: clinicopathologic features and surgical outcomes. Hepatogastroenterology. 2002;49:326–9.PubMed

11.

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

12.

Morimoto Y, Tanaka Y, Ito T, Nakahara M, Nakaba H, Nishida T, et al. Long-term survival and prognostic factors in the surgical treatment for intrahepatic cholangiocarcinoma. J Hepatobiliary Pancreat Surg. 2003;10:432–40.PubMedCrossRef

13.

Yeh CN, Jan YY, Yeh TS, Hwang TL, Chen MF. Hepatic resection of the intraductal papillary type of peripheral cholangiocarcinoma. Ann Surg Oncol. 2004;11:606–11.PubMedCrossRef

14.

Shimada K, Sano T, Sakamoto Y, Esaki M, Kosuge T, Ojima H. Surgical outcomes of the mass-forming plus periductal infiltrating types of intrahepatic cholangiocarcinoma: a comparative study with the typical mass-forming type of intrahepatic cholangiocarcinoma. World J Surg. 2007;31:2016–22.PubMedCrossRef

15.

Yamamoto Y, Shiamda K, Sakamoot Y, Esaki M, Nara S, Ban D. Clinicopathological characteristics of intrahepatic cholangiocellular carcinoma presenting intrahepatic bile duct growth. J Surg Oncol. 2009;99:161–5.PubMedCrossRef

16.

Guglielmi A, Ruzzenente A, Campagnaro T, Pachera S, Valdegamberi A, Nicoli P, et al. Intrahepatic cholangiocarcinoma: prognostic factors after surgical resection. World J Surg. 2009;33:1247–54.PubMedCrossRef

17.

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

18.

Ercolani G, Vetrone G, Grazi GL, et al. Intrahepatic cholangiocarcinoma: primary liver resection and aggressive multimodal treatment of recurrence significantly prolong survival. Ann Surg. 2010;252:107–14.PubMedCrossRef

19.

Murakami Y, Uemura K, Sudo T, et al. Prognostic factors after surgical resection for intrahepatic, hilar and distal cholangiocarcinoma. Ann Surg Oncol. 2011;3:651–8.CrossRef

20.

Yamamoto M, Ariizumi S. Surgical outcomes of intrahepatic cholangiocarcinoma. Surg Today. 2011;41:896–902.PubMedCrossRef

21.

Ohashi K, Nakajima Y, Kanehiro H, Tsutsumi M, Taki J, Aomatsu Y, et al. Ki-ras mutation and p53 protein expressions in intrahepatic cholangiocarcinomas: relation to gross tumor morphology. Gastroenterology. 1995;109:1612–7.PubMedCrossRef

Title: Periductal infiltrating type of intrahepatic cholangiocarcinoma: a rare macroscopic type without any apparent mass
Authors: Masanori Uno
Kazuaki Shimada
Yusuke Yamamoto
Satoshi Nara
Minoru Esaki
Yoshihiro Sakamoto
Tomoo Kosuge
Hidenori Ojima
Publication date: 01-12-2012
Publisher: Springer Japan
Published in: Surgery Today / Issue 12/2012
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI: https://doi.org/10.1007/s00595-012-0145-5

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Springer Medicine

Periductal infiltrating type of intrahepatic cholangiocarcinoma: a rare macroscopic type without any apparent mass

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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