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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 12/2018

01-11-2018 | Hepatobiliary Tumors

Patterns of Distribution of Hepatic Nodules (Single, Satellites or Multifocal) in Intrahepatic Cholangiocarcinoma: Prognostic Impact After Surgery

Authors: Simone Conci, MD, Andrea Ruzzenente, MD, PhD, Luca Viganò, MD, PhD, Giorgio Ercolani, MD, PhD, Andrea Fontana, MD, Fabio Bagante, MD, Francesca Bertuzzo, MD, Andrea Dore, MD, Antonio Daniele Pinna, MD, Guido Torzilli, MD, Calogero Iacono, MD, Alfredo Guglielmi, MD

Published in: Annals of Surgical Oncology | Issue 12/2018

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Abstract

Objective

We aimed to compare the clinicopathological features and survival after surgery of patients with intrahepatic cholangiocarcinoma (ICC) according to the patterns of distribution of hepatic nodules.

Methods

A retrospective analysis of a multi-institutional series of 259 patients with resected ICC was carried out. Patients were further classified according to the pattern of distribution of hepatic nodules: single tumors (type I), single tumors with satellites in the same liver segment (type II), or multifocal tumors (type III).

Results

Overall, 64.5% of patients had type I, 21.9% had type II, and 13.5% had type III. The 5-year overall survival rate was 49.4, 34.2, and 9.9% for types I, II, and III, respectively (p < 0.001). A multivariate survival analysis identified the following independent prognostic factors: pattern types II and III (p = 0.001 and p = 0.001, respectively), size ≥ 50 mm (p = 0.021), lymph node (LN) metastases (p = 0.005), and R1 resections (p = 0.019). We stratified survival for each type of pattern according to the other prognostic factors identified in the multivariate analysis. N0 and R0 patients with type II and III tumors had encouraging long-term results. Conversely, patients with LN metastases and R1 resections had poor prognosis, particularly patients with type III tumors.

Conclusion

ICC has distinct patterns of distribution with different prognoses that should be considered when making therapeutic decisions. Patients with type III tumors had a significantly worse prognosis, and the benefits of upfront surgery should be carefully evaluated.
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Metadata
Title
Patterns of Distribution of Hepatic Nodules (Single, Satellites or Multifocal) in Intrahepatic Cholangiocarcinoma: Prognostic Impact After Surgery
Authors
Simone Conci, MD
Andrea Ruzzenente, MD, PhD
Luca Viganò, MD, PhD
Giorgio Ercolani, MD, PhD
Andrea Fontana, MD
Fabio Bagante, MD
Francesca Bertuzzo, MD
Andrea Dore, MD
Antonio Daniele Pinna, MD
Guido Torzilli, MD
Calogero Iacono, MD
Alfredo Guglielmi, MD
Publication date
01-11-2018
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 12/2018
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-018-6669-1

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