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World Journal of Surgery

Published in:

01-11-2008

Perineural Invasion Is a Prognostic Factor in Intrahepatic Cholangiocarcinoma

Authors: Kazuhisa Shirai, Tomoki Ebata, Koji Oda, Hideki Nishio, Tetsuro Nagasaka, Yuji Nimura, Masato Nagino

Published in: World Journal of Surgery | Issue 11/2008

Abstract

Background

Perineural invasion is commonly observed in biliary tract cancer and is an independent prognostic factor. Since intrahepatic cholangiocarcinoma (ICC) develops from biliary epithelia in the liver, ICC may share the same characteristics in terms of the prognostic implications of perineural invasion. The aim of this study was to evaluate the clinical significance of perineural invasion in ICC.

Methods

A total of 59 patients with ICC who underwent hepatectomy were retrospectively reviewed. The numbers of nerves with and without tumor involvement were counted. The perineural invasion index (PNI) was calculated as the number of involved nerves divided by the total number of nerves examined. Predictors for perineural invasion and prognostic factors were analyzed.

Results

Perineural invasion was observed in 47 of 59 (80%) patients, and the median PNI was 0.082. The macroscopic tumor appearance and tumor location were significantly associated with perineural invasion (p = 0.013 and 0.032, respectively). Univariate and multivariate analyses (excluding seven in-hospital deaths) revealed that histologic grade, the presence of perineural invasion, nodal metastasis, and intrahepatic metastasis were independent prognostic factors. The survival rate of the patients with (n = 42) or without (n = 10) perineural invasion was 17 and 80% at 3 years; and 17 and 70% at 5 years, respectively (p = 0.001).

Conclusion

Perineural invasion is frequently found in patients with ICC and is an independent prognostic factor. ICC is an aggressive tumor similar to other biliary tract cancers. Because perineural invasion is a histologic marker of aggressiveness, it potentially has a role as a determinant of patient selection for adjuvant therapy.

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Title: Perineural Invasion Is a Prognostic Factor in Intrahepatic Cholangiocarcinoma
Authors: Kazuhisa Shirai
Tomoki Ebata
Koji Oda
Hideki Nishio
Tetsuro Nagasaka
Yuji Nimura
Masato Nagino
Publication date: 01-11-2008
Publisher: Springer-Verlag
Published in: World Journal of Surgery / Issue 11/2008
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-008-9726-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Perineural Invasion Is a Prognostic Factor in Intrahepatic Cholangiocarcinoma

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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