Objective: An optimal therapeutic strategy for intrahepatic cholangiocarcinoma (ICC) has not yet been determined. Herein we focused on intrahepatic tumor location and retrospectively analyzed tumor characteristics depending on location to elucidate a location-specific therapeutic strategy for ICC. Methods: Sixty-five ICC patients were divided into three groups based on the distance between the innermost portion of the tumor and portal vein branches observed on preoperative imaging: peripheral, intermediate and central ICC. Results: Median disease-specific survival (DSS) of the peripheral ICC was not reached, whereas median DSS was 32.9 months in intermediate ICC and 25.2 months in central ICC (p <0.05). Vascular invasion was observed in all groups (56-92%). Bile duct invasion to the first branch of the hepatic duct was more commonly observed in central ICC (43%) compared with the peripheral and intermediate ICC (0-8%). Lymph node metastasis was not observed in peripheral ICC, whereas it was frequently observed in intermediate and central ICC (39-44%). A Cox regression analysis revealed sufficient RDI (≥58.3%) of adjuvant chemotherapy (AC) significantly increased the length of DSS (HR: 0.205). Based on these data, we have proposed a location-specific therapeutic strategy as follows: peripheral ICC requires anatomical resection without lymphadenectomy; intermediate ICC requires anatomical resection with lymphadenectomy and sufficient doses of AC; and central ICC requires anatomical resection with extrahepatic bile duct resection, caudate lobectomy, lymphadenectomy, and sufficient doses of AC. Conclusion: We propose an intrahepatic tumor location-specific therapeutic strategy for ICC. This information could contribute to the appropriate therapeutic management of patients with ICC.
Kosaka, H., Kaibori, M., Matsui, K., Ishizaki, M., Matsushima, H., Sekimoto, M. (2021). Investigation of a Tumor Location-Specific Therapeutic Strategy for Intrahepatic Cholangiocarcinoma. Asian Pacific Journal of Cancer Prevention, 22(5), 1485-1493. doi: 10.31557/APJCP.2021.22.5.1485
MLA
Hisashi Kosaka; Masaki Kaibori; Kosuke Matsui; Morihiko Ishizaki; Hideyuki Matsushima; Mitsugu Sekimoto. "Investigation of a Tumor Location-Specific Therapeutic Strategy for Intrahepatic Cholangiocarcinoma". Asian Pacific Journal of Cancer Prevention, 22, 5, 2021, 1485-1493. doi: 10.31557/APJCP.2021.22.5.1485
HARVARD
Kosaka, H., Kaibori, M., Matsui, K., Ishizaki, M., Matsushima, H., Sekimoto, M. (2021). 'Investigation of a Tumor Location-Specific Therapeutic Strategy for Intrahepatic Cholangiocarcinoma', Asian Pacific Journal of Cancer Prevention, 22(5), pp. 1485-1493. doi: 10.31557/APJCP.2021.22.5.1485
VANCOUVER
Kosaka, H., Kaibori, M., Matsui, K., Ishizaki, M., Matsushima, H., Sekimoto, M. Investigation of a Tumor Location-Specific Therapeutic Strategy for Intrahepatic Cholangiocarcinoma. Asian Pacific Journal of Cancer Prevention, 2021; 22(5): 1485-1493. doi: 10.31557/APJCP.2021.22.5.1485
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