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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 2/2017

01-02-2017 | Hepatobiliary Tumors

Prognostic Significance of Tumor Necrosis in Hilar Cholangiocarcinoma

Authors: Georgi Atanasov, MD, Katrin Schierle, MD, Hans-Michael Hau, MD, Corinna Dietel, PhD, Felix Krenzien, MD, Andreas Brandl, MD, Georg Wiltberger, MD, Julianna Paulina Englisch, Simon C. Robson, MD, PhD, Anja Reutzel-Selke, PhD, Andreas Pascher, MD, PhD, Sven Jonas, MD, PhD, Johann Pratschke, MD, PhD, Christian Benzing, MD, Moritz Schmelzle, MD, PhD

Published in: Annals of Surgical Oncology | Issue 2/2017

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Abstract

Background

Tumor necrosis and peritumoral fibrosis have both been suggested to have a prognostic value in selected solid tumors. However, little is known regarding their influence on tumor progression and prognosis in hilar cholangiocarcinoma (HC).

Methods

Surgically resected tumor specimens of HC (n = 47) were analyzed for formation of necrosis and extent of peritumoral fibrosis. Tumor necrosis and grade of fibrosis were assessed histologically and correlated with clinicopathological characteristics, tumor recurrence, and patients’ survival. Univariate Kaplan–Meier analysis and a stepwise multivariable Cox regression model were applied.

Results

Mild peritumoral fibrosis was evident in 12 tumor samples, moderate peritumoral fibrosis in 20, and high-grade fibrosis in 15. Necrosis was evident in 19 of 47 tumor samples. Patients with tumors characterized by necrosis showed a significantly decreased 5-year recurrence-free survival (37.9 vs. 25.7 %; p < .05) and a significantly decreased 5-year overall survival (42.6 vs. 12.4 %; p < .05), when compared with patients with tumors showing no necrosis. R status, tumor recurrence, and tumor necrosis were of prognostic value in the univariate analysis (all p < .05). Multivariate survival analysis confirmed tumor necrosis (p = .038) as the only independent prognostic variable.

Conclusions

The assessment of tumor necrosis appears as a valuable additional prognostic tool in routine histopathological evaluation of HC. These observations might have implications for monitoring and more individualized multimodal therapeutic strategies.
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Metadata
Title
Prognostic Significance of Tumor Necrosis in Hilar Cholangiocarcinoma
Authors
Georgi Atanasov, MD
Katrin Schierle, MD
Hans-Michael Hau, MD
Corinna Dietel, PhD
Felix Krenzien, MD
Andreas Brandl, MD
Georg Wiltberger, MD
Julianna Paulina Englisch
Simon C. Robson, MD, PhD
Anja Reutzel-Selke, PhD
Andreas Pascher, MD, PhD
Sven Jonas, MD, PhD
Johann Pratschke, MD, PhD
Christian Benzing, MD
Moritz Schmelzle, MD, PhD
Publication date
01-02-2017
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 2/2017
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-016-5472-0

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