Wu RuiYang1,2, Yang ZhiMing2, Feng Jiao2,3, Zhang Liang2, Zhang Gang4,5. 1. Department of General Surgery, Sichuan Provincial Hospital for Women and Children (Affiliated Women and Children's Hospital of Chengdu Medical College), Chengdu, 610045, China. 2. Department of Vascular Surgery, The First Affiliated Hospital of Chengdu Medical College, Chengdu, 610500, China. 3. Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Chengdu Medical College, Chengdu, 610500, China. 4. Department of General Surgery, Sichuan Provincial Hospital for Women and Children (Affiliated Women and Children's Hospital of Chengdu Medical College), Chengdu, 610045, China. 1419174430@qq.com. 5. Executive Office of Sichuan Provincial Hospital for Women and Children, No. 290, West Second Street, Shayan Village, Jinyang Road, Wuhou District, Chengdu City, Sichuan Province, China. 1419174430@qq.com.
Abstract
BACKGROUND: The AJCC made four changes to T category in the 8th AJCC stage for ICC, but this is a topic of debate. METHODS: Data from 820 patients with ICC were extracted from the SEER database. Survival analysis of the 8th AJCC stage was examined. RESULTS: To verify the four T staging changes by survival analysis: prognosis of patients with tumor size > 5 cm was poorer than that with tumor size ≤ 5 cm (P < 0.05); in N0M0 cohort, there was no significant difference in survival between solitary tumor with vascular invasion and multiple tumors (P = 0.092), tumor perforating the visceral peritoneum with and without involving local extrahepatic structures by direct invasion (P = 0.470), and tumor with and without periductal invasion (PI) (P = 0.220). The prognosis of patients with ≥ 4 positive lymph nodes was relatively poor compared with 1-3 positive lymph nodes (P = 0.037) and similar to patients with stage IV (8th AJCC, P = 0.585). CONCLUSION: This study found that there was no significant difference in survival between tumor perforating the visceral peritoneum with and without involving local extrahepatic structures by direct invasion, whereas other T staging changes were effective. The inclusion of the number of positive lymph nodes in the 8th AJCC stage may improve prognostic discrimination in ICC patients.
BACKGROUND: The AJCC made four changes to T category in the 8th AJCC stage for ICC, but this is a topic of debate. METHODS: Data from 820 patients with ICC were extracted from the SEER database. Survival analysis of the 8th AJCC stage was examined. RESULTS: To verify the four T staging changes by survival analysis: prognosis of patients with tumor size > 5 cm was poorer than that with tumor size ≤ 5 cm (P < 0.05); in N0M0 cohort, there was no significant difference in survival between solitary tumor with vascular invasion and multiple tumors (P = 0.092), tumor perforating the visceral peritoneum with and without involving local extrahepatic structures by direct invasion (P = 0.470), and tumor with and without periductal invasion (PI) (P = 0.220). The prognosis of patients with ≥ 4 positive lymph nodes was relatively poor compared with 1-3 positive lymph nodes (P = 0.037) and similar to patients with stage IV (8th AJCC, P = 0.585). CONCLUSION: This study found that there was no significant difference in survival between tumor perforating the visceral peritoneum with and without involving local extrahepatic structures by direct invasion, whereas other T staging changes were effective. The inclusion of the number of positive lymph nodes in the 8th AJCC stage may improve prognostic discrimination in ICCpatients.
Authors: Angela Lamarca; Alvaro Santos-Laso; Kirsten Utpatel; Adelaida La Casta; Simone Stock; Alejandro Forner; Jorge Adeva; Trine Folseraas; Luca Fabris; Rocio I R Macias; Marcin Krawczyk; Marek Krawczyk; Vincenzo Cardinale; Chiara Braconi; Domenico Alvaro; Matthias Evert; Jesus M Banales; Juan W Valle Journal: Hepatology Date: 2021-06 Impact factor: 17.425