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Open Access 01-06-2014 | Hepatobiliary Tumors

Long-term Survival of Patients with Cholangiolocellular Carcinoma After Curative Hepatectomy

Authors: Shun-ichi Ariizumi, MD, Yoshihito Kotera, MD, Satoshi Katagiri, MD, Masayuki Nakano, MD, Yasuni Nakanuma, MD, Akiko Saito, MD, Masakazu Yamamoto, MD

Published in: Annals of Surgical Oncology | Special Issue 3/2014

Abstract

Background

Cholangiolocellular carcinoma (CoCC) has distinct pathological characteristics, and CoCC is considered to originate from hepatic progenitor or stem cells. However, the surgical outcome of CoCC has not been clarified in detail.

Methods

We retrospectively studied 275 patients with intrahepatic cholangiocarcinoma (ICC) who underwent hepatectomy between 1990 and 2011. Surgical outcomes were compared between 29 patients with CoCC and 130 patients with mass-forming (MF) type ICC since all patients with CoCC showed MF type on macroscopic findings.

Results

The number of patients with chronic liver disease was significantly higher in the CoCC group than in the ICC group. The number of patients with abnormal levels of CA19-9 was significantly lower in the CoCC group than in the ICC group. Portal vein invasion and intrahepatic metastasis were significantly lower in patients with CoCC group than in the ICC group. In the CoCC group, 15 of 28 patients survived for more than 5 years after curative surgery whereas 15 of 102 patients with ICC survived for more than 5 years after curative surgery. The 5-year survival rate was significantly higher in patients with CoCC (75 %) than in patients with ICC (33 %, p = 0.0005). Multivariate analysis showed CoCC, absence of portal vein invasion or hepatic vein invasion, and absence of intrahepatic metastasis to be significant independent prognostic factors for overall survival in patients with MF-type ICC and CoCC.

Conclusions

CoCC is rare, but patients with CoCC had special characteristics with favorable long-term survival due to its less invasive histopathologic characteristics.

Steiner PE and Higginson J. Cholangiolocellular carcinoma of the liver. Cancer. 1959;12:753–9.PubMedCrossRef

Nakanuma Y, Sripa B, Vatanasapt V. Intrahepatic cholangiocarcinoma. In: Hamilton SR, Aaltonen LA, editors. World Health Classification of Tumours. Pathology and Genetics of Tumours of the Digestive System. Lyon: IARC Press; 2000. p 173–80.

Liver Cancer Study Group of Japan. General rules for the clinical and pathological study of primary liver cancer. 4th ed. Tokyo, Japan: Kanehara, 2000.

Shiota K, Taguchi J, Nakashima O, Nakashima M, Kojiro M. Clinicopathologic study on cholangiolocellular carcinoma. Oncol Rep. 2001;8:263–8.PubMed

Theise ND, Yao JL, Harada K, Hytiroglou P, Portmann B, Thung SN, et al. Hepatic “stem cell” malignancies in adults four cases. Histopathology. 2003;43:263–71.PubMedCrossRef

Kozaka K, Sasaki M, Fujii T, Harada K, Zen Y, Sato Y, et al. A subgroup of intrahepatic cholangiocarcinoma with an infiltrating replacement growth pattern and a resemblance to reactive proliferating bile ductules: “bile ductular carcinoma”. Histopathology. 2007;51:390–400.PubMedCrossRef

Komuta M, Spee B, Borght S, Vos R, Verslype C, Aerts R, et al. Clinicopathological study on cholangiolocellular carcinoma suggesting hepatic progenitor cell origin. Hepatology. 2008;47:1544–56.PubMedCrossRef

Liver Cancer Study Group of Japan. General rules for the clinical and pathological study of primary liver cancer. 5th ed. Tokyo, Japan: Kanehara, 2009.

Theise ND, Nakashima O, Park YN. Combined hepatocellular-cholangiocarcinoma. In: Bosman FT, Carneiro F, Hruban RH, Theise ND, eds. WHO classification of tumours of the digestive system. Lyon, France: IARC Press, 2010:225–7.

10.

Nakano M. Pathology of cholangiolocellular carcinoma. Tan To Sui (J Biliary Tract and Pancreas). 2004;25:343–9 (in Japanese).

11.

Maeno S, Kondo F, Sano K, Takada T, Asano T. Morphometric and immunohistochemical study of cholangiolocellular carcinoma: comparison with non-neoplastic cholangiole, interlobular duct and septal duct. J Hepatobiliary Pancreat Sci. 2012;19:289–96.PubMedCentralPubMedCrossRef

12.

Fukukura Y, Hamanoue M, Fujiyoshi F, Sasaki M, Haruta K, Inoue H, et al. Cholangiolocellular carcinoma of the liver: CT and MR findings. J Comput Assist Tomogr. 2000;24:809–12.PubMedCrossRef

13.

Motosugi U, Ichikawa T, Nakajima H, Araki T, Matsuda M, Suzuki T, et al. Cholangiolocellular carcinoma of the liver: imaging findings. J Comput Assist Tomogr. 2009;33:682–8.PubMedCrossRef

14.

Terminology Committee of the International Hepato-Pancreato-Biliary Association. Modified from the Brisbane 2000 Terminology of liver anatomy and resections. HPB (Oxford). 2000;2:333–9.

15.

Nakanuma Y, Sato Y, Harada K, Sasaki M, Xu J, Ikeda H. Pathological classification of intrahepatic cholangiocarcinoma based on a new concept. World J Hepatol. 2010;27:419–27.CrossRef

16.

Nakanuma Y, Sato Y, Ikeda H, Harada K, Kobayashi M, Sano K, et al. Intrahepatic cholangiocarcinoma with predominant “ductal plate malformation” pattern: a new subtype. Am J Surg Pathol. 2012;36:1629–35.PubMedCrossRef

17.

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

18.

Ariizumi S, Kotera Y, Katagiri S, Nakano M, Yamamoto M. Combined hepatocellular-cholangiocarcinoma had poor outcomes after hepatectomy regardless of Allen and Lisa class or the predominance of intrahepatic cholangiocarcinoma cells within the tumor. Ann Surg Oncol. 2012;19:1628–36.PubMedCrossRef

19.

Sobin LH, Gospodarowics MK, Wittekind Ch. International union against cancer: TNM classification of malignant tumours, 7th edition. Chichester, West Sussex, UK: Wiley-Blackwell; 2009.

20.

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

21.

Okabayashi T, Yamamoto J, Kosuge T, Shimada K, Yamasaki S, Takayama T, et al. A new staging system for mass-forming intrahepatic cholangiocarcinoma: analysis of preoperative and postoperative variables. Cancer. 2001;92:2374–83.PubMedCrossRef

22.

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

23.

Paik KY, Jung JC, Heo JS, Choi SH, Choi DW, Kim YI. What prognostic factors are important for resected intrahepatic cholangiocarcinoma? J Gastroenterol Hepatol. 2008;23:766–70.PubMedCrossRef

24.

Shimada K, Sano T, Nara S, Esaki M, Sakamoto Y, Kosuge T, et al. Therapeutic value of lymph node dissection during hepatectomy in patients with intrahepatic cholangiocellular carcinoma with negative lymph node involvement. Surgery. 2009;145:411–6.PubMedCrossRef

25.

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

26.

Uchiyama K, Yamamoto M, Yamaue H, Ariizumi S, Aoki T, Kokudo N, et al. Impact of nodal involvement on surgical outcomes of intrahepatic cholangiocarcinoma: a multicenter analysis by the survey of the study group for hepatic surgery of the Japanese Society of Hepato-Biliary-Pancreatic Surgery. J Hepatobiliary Pancreat Sci. 2011;18:443–52.PubMedCrossRef

27.

Ariizumi S, Kotera Y, Takahashi Y, Katagiri S, Chen IP, Ota T, et al. Mass-forming intrahepatic cholangiocarcinoma with marked enhancement on arterial-phase computed tomography reflects favorable surgical outcomes. J Surg Oncol. 2011;104:130–9.PubMedCrossRef

28.

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

29.

Uenishi T, Yamazaki O, Tanaka H, Takemura S, Yamamoto T, Tanaka S, et al. Serum cytokeratin 19 fragment (CYFRA21-1) as a prognostic factor in intrahepatic cholangiocarcinoma. Ann Surg Oncol. 2008;15:583–9.PubMedCrossRef

30.

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

31.

Weinbren K, Mutum SS. Pathological aspect of cholangiocarcinoma. J Pathol. 1983;139:217–38.PubMedCrossRef

32.

Komuta M, Govaere O, Vandecaveye V, Akiba J, Van Steenbergen W, Verslype C, et al. Histological diversity in cholangiocellular carcinoma reflects the different cholangiocyte phenotypes. Hepatology. 2012;55:1876–88.PubMedCrossRef

Title: Long-term Survival of Patients with Cholangiolocellular Carcinoma After Curative Hepatectomy
Authors: Shun-ichi Ariizumi, MD
Yoshihito Kotera, MD
Satoshi Katagiri, MD
Masayuki Nakano, MD
Yasuni Nakanuma, MD
Akiko Saito, MD
Masakazu Yamamoto, MD
Publication date: 01-06-2014
Publisher: Springer US
Published in: Annals of Surgical Oncology / Issue Special Issue 3/2014
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-014-3582-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Long-term Survival of Patients with Cholangiolocellular Carcinoma After Curative Hepatectomy

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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