Georgi Atanasov1, Katrin Schierle2, Hans-Michael Hau3, Corinna Dietel3, Felix Krenzien4, Andreas Brandl4, Georg Wiltberger3, Julianna Paulina Englisch4, Simon C Robson5, Anja Reutzel-Selke4, Andreas Pascher4, Sven Jonas6, Johann Pratschke4, Christian Benzing4, Moritz Schmelzle4. 1. Department of Surgery, Campus Virchow and Mitte, Charité-Universitätsmedizin Berlin, Berlin, Germany. georgi.atanasov@charite.de. 2. Institute of Pathology, University Hospital Leipzig, Leipzig, Germany. 3. Department of Visceral-, Transplantation-, Thoracic- and Vascular Surgery, University Hospital Leipzig, Leipzig, Germany. 4. Department of Surgery, Campus Virchow and Mitte, Charité-Universitätsmedizin Berlin, Berlin, Germany. 5. The Transplant Institute and Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard University, Boston, MA, USA. 6. Department of Hepato-Pancreato-Biliary Surgery, 310Klinik Nürnberg, Nuremberg, Germany.
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.
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.
Authors: Georgi Atanasov; Corinna Dietel; Linda Feldbrügge; Christian Benzing; Felix Krenzien; Andreas Brandl; Elli Mann; Julianna Paulina Englisch; Katrin Schierle; Simon C Robson; Katrin Splith; Mehmet Haluk Morgul; Anja Reutzel-Selke; Sven Jonas; Andreas Pascher; Marcus Bahra; Johann Pratschke; Moritz Schmelzle Journal: Oncoimmunology Date: 2017-06-28 Impact factor: 8.110
Authors: Georgi Atanasov; Karoline Dino; Katrin Schierle; Corinna Dietel; Gabriela Aust; Johann Pratschke; Daniel Seehofer; Moritz Schmelzle; Hans-Michael Hau Journal: Ann Transplant Date: 2020-03-13 Impact factor: 1.530
Authors: Jihwan Yoo; Yoon Jin Cha; Hun Ho Park; Mina Park; Bio Joo; Sang Hyun Suh; Sung Jun Ahn Journal: Cancers (Basel) Date: 2022-03-26 Impact factor: 6.639
Authors: Georgi Atanasov; Karoline Dino; Katrin Schierle; Corinna Dietel; Gabriela Aust; Johann Pratschke; Daniel Seehofer; Moritz Schmelzle; Hans-Michael Hau Journal: World J Surg Oncol Date: 2019-12-12 Impact factor: 2.754
Authors: Georgi Atanasov; Corinna Dietel; Linda Feldbrügge; Christian Benzing; Felix Krenzien; Andreas Brandl; Shadi Katou; Katrin Schierle; Simon C Robson; Katrin Splith; Georg Wiltberger; Anja Reutzel-Selke; Sven Jonas; Andreas Pascher; Marcus Bahra; Johann Pratschke; Moritz Schmelzle Journal: Oncotarget Date: 2018-07-06