Liang-Shuo Hu1, Matthew Weiss2, Irinel Popescu3, Hugo P Marques4, Luca Aldrighetti5, Shishir K Maithel6, Carlo Pulitano7, Todd W Bauer8, Feng Shen9, George A Poultsides10, Oliver Soubrane11, Guillaume Martel12, B Groot Koerkamp13, Endo Itaru14, Timothy M Pawlik15. 1. Department of Hepatobiliary Surgery and Institute of Advanced Surgical Technology and Engineering, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China. 2. Department of Surgery, Johns Hopkins Hospital, Baltimore, Maryland. 3. Department of Surgery, Fundeni Clinical Institute, Bucharest, Romania. 4. Department of Surgery, Curry Cabral Hospital, Lisbon, Portugal. 5. Department of Surgery, Ospedale San Raffaele, Milan, Italy. 6. Department of Surgery, Emory University, Atlanta, Georgia. 7. Department of Surgery, Royal Prince Alfred Hospital, University of Sydney, Sydney, Australia. 8. Department of Surgery, University of Virginia, Charlottesville, Virginia. 9. Department of Surgery, Eastern Hepatobiliary Surgery Hospital, Shanghai, China. 10. Department of Surgery, Stanford University, Stanford, California. 11. Department of Hepatobiliopancreatic Surgery and Liver Transplantation, AP-HP, Beaujon Hospital, Clichy, France. 12. Division of General Surgery, Department of Surgery, University of Ottawa, Ottawa, Ontario, Canada. 13. Department of Surgery, Erasmus University Medical Centre, Rotterdam, The Netherlands. 14. Division of Gastroenterological Surgery, Yokohama City University School of Medicine, Yokohama, Japan. 15. Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.
Abstract
BACKGROUND: Microvascular invasion (MiVI) is a histological feature of intrahepatic cholangiocarcinoma (ICC) that may be associated with biological behavior. We sought to investigate the impact of MiVI on long-term survival of patients undergoing curative-intent resection for ICC. METHODS: A total of 1089 patients undergoing curative-intent resection for ICC were identified. Data on clinicopathological characteristics, disease-free survival (DFS), and overall survival (OS) were compared among patients with no vascular invasion (NoVI), MiVI, and macrovascular invasion (MaVI). RESULTS: A total of 249 (22.9%) patients had MiVI, while 149 (13.7%) patients had MaVI (±MiVI). MiVI was associated with higher incidence of perineural, biliary and adjacent organ invasion, and satellite lesions (all P < 0.01). On multivariable analysis, MiVI was an independent risk factor of DFS (hazard ratios [HR] 1.5; 95%confidence intervals [CI], 1.3-1.9; P < 0.001), but not OS (HR 1.1; 95%CI, 0.9-1.3; P = 0.379). While MiVI and MaVI patients had similar DFS (median, MiVI 14.0 vs MaVI 12.0 months, HR 0.9; 95%CI, 0.7-1.2; P = 0.377), OS was better among MiVI patients (median, MiVI 39.0 vs MaVI 21.0 months, HR 0.7; 95%CI, 0.5-0.8; P = 0.002). Whereas nodal metastasis, R1 margin, and postoperative morbidity were associated with early death (≤18 months) among patients with MiVI, only nodal metastasis was associated with late (>18 months) prognosis. CONCLUSIONS: Roughly 1 out of 5 patients with resected ICC had MiVI. MiVI was associated with advanced tumor characteristics and a higher risk of tumor recurrence.
BACKGROUND: Microvascular invasion (MiVI) is a histological feature of intrahepatic cholangiocarcinoma (ICC) that may be associated with biological behavior. We sought to investigate the impact of MiVI on long-term survival of patients undergoing curative-intent resection for ICC. METHODS: A total of 1089 patients undergoing curative-intent resection for ICC were identified. Data on clinicopathological characteristics, disease-free survival (DFS), and overall survival (OS) were compared among patients with no vascular invasion (NoVI), MiVI, and macrovascular invasion (MaVI). RESULTS: A total of 249 (22.9%) patients had MiVI, while 149 (13.7%) patients had MaVI (±MiVI). MiVI was associated with higher incidence of perineural, biliary and adjacent organ invasion, and satellite lesions (all P < 0.01). On multivariable analysis, MiVI was an independent risk factor of DFS (hazard ratios [HR] 1.5; 95%confidence intervals [CI], 1.3-1.9; P < 0.001), but not OS (HR 1.1; 95%CI, 0.9-1.3; P = 0.379). While MiVI and MaVIpatients had similar DFS (median, MiVI 14.0 vs MaVI 12.0 months, HR 0.9; 95%CI, 0.7-1.2; P = 0.377), OS was better among MiVIpatients (median, MiVI 39.0 vs MaVI 21.0 months, HR 0.7; 95%CI, 0.5-0.8; P = 0.002). Whereas nodal metastasis, R1 margin, and postoperative morbidity were associated with early death (≤18 months) among patients with MiVI, only nodal metastasis was associated with late (>18 months) prognosis. CONCLUSIONS: Roughly 1 out of 5 patients with resected ICC had MiVI. MiVI was associated with advanced tumor characteristics and a higher risk of tumor recurrence.
Authors: Woo Jin Choi; Phil J Williams; Marco P A W Claasen; Tommy Ivanics; Marina Englesakis; Steven Gallinger; Bettina Hansen; Gonzalo Sapisochin Journal: Ann Surg Oncol Date: 2022-02-18 Impact factor: 5.344
Authors: T Peter Kingham; Victoria G Aveson; Alice C Wei; Jason A Castellanos; Peter J Allen; Daniel P Nussbaum; Yinin Hu; Michael I D'Angelica Journal: Curr Probl Surg Date: 2020-06-30 Impact factor: 1.909
Authors: Felix Hahn; Lukas Müller; Aline Mähringer-Kunz; Sebastian Schotten; Christoph Düber; Jan B Hinrichs; Sabine K Maschke; Peter R Galle; Fabian Bartsch; Hauke Lang; Arndt Weinmann; Roman Kloeckner Journal: PLoS One Date: 2020-02-03 Impact factor: 3.240