Detailed Abstract
[E-poster - Liver (Liver Disease/Surgery)]
[EP 080] Impact of Pathological Subclassification of Intrahepatic Cholangiocarcinoma on Lymph Node Metastasis
Mizuki YOSHIDA 1, Masahiko KINOSHITA 1, Koichi NAKANISHI 1, Kosuke HATTA 1, Takahito KAWAGUCHI 1, Naoki TANI 1, Shuhei KUSHIYAMA 1, Ryota TANAKA 1, Shigeaki KURIHARA 1, Go OHIRA 1, Kohei NISHIO 1, Hiroji SHINKAWA 1, Kenjiro KIMURA 1, Takeaki ISHIZAWA 1
1 Hepato-Biliary-Pancreatic Surgery, Osaka Metropolitan University, JAPAN
Background : Lymph node metastasis (LNM) strongly influences the poor prognosis of intrahepatic cholangiocarcinoma (ICC). WHO classification of Tumour 5th edition proposed pathological subclassifications of ICCs (small and large duct-types), however, clinical characteristics including their role in LNM remain to be unclear. This study aimed to investigate risk factors for LNM of ICCs with consideration to subclassifications.
Methods : This study included 118 patients who underwent liver resection for ICC. Based on the pathological diagnosis, patients were diagnosed as the small and large duct-type ICC. The impact of potential risk factors including subclassification for LNM were investigated.
Results : ICCs in 54 patients were subclassified into small duct-type, and those in 64 patients into large duct-type. Thirty-eight of 118 patients had LNM in this cohort. Univariate analysis showed that large duct-type ICC, serum CA19-9 levels ≥ 400U/mL, tumor diameter ≥ 5cm, pathological portal vein invasion and perineural invasion were significant risk factors for LNM. Moreover, multivariate analysis showed that large duct-type ICC and pathological portal vein invasion were independent risk factors. Preoperative LNM risk factors for each subclassification were also investigated in univariate analyses, tumor diameter ≥ 5cm and CA19-9 ≥ 400U/mL were significant risk factors in large and small duct-type, respectively.
Conclusions : Large duct-type was an independent risk factor for LNM of ICC. The risk of LNM was relatively low in small duct-type, however, the risk may be high in patients with CA19-9 ≥ 400 U/mL. Although these subclassifications were currently diagnosed pathologically, the establishment of preoperative diagnostic tool may contribute for appropriate surgical strategies.
Methods : This study included 118 patients who underwent liver resection for ICC. Based on the pathological diagnosis, patients were diagnosed as the small and large duct-type ICC. The impact of potential risk factors including subclassification for LNM were investigated.
Results : ICCs in 54 patients were subclassified into small duct-type, and those in 64 patients into large duct-type. Thirty-eight of 118 patients had LNM in this cohort. Univariate analysis showed that large duct-type ICC, serum CA19-9 levels ≥ 400U/mL, tumor diameter ≥ 5cm, pathological portal vein invasion and perineural invasion were significant risk factors for LNM. Moreover, multivariate analysis showed that large duct-type ICC and pathological portal vein invasion were independent risk factors. Preoperative LNM risk factors for each subclassification were also investigated in univariate analyses, tumor diameter ≥ 5cm and CA19-9 ≥ 400U/mL were significant risk factors in large and small duct-type, respectively.
Conclusions : Large duct-type was an independent risk factor for LNM of ICC. The risk of LNM was relatively low in small duct-type, however, the risk may be high in patients with CA19-9 ≥ 400 U/mL. Although these subclassifications were currently diagnosed pathologically, the establishment of preoperative diagnostic tool may contribute for appropriate surgical strategies.
SESSION
E-poster
E-Session 03/21 ALL DAY