Typing and staging and treatment of intrahepatic cholangiocarcinoma / 中华消化外科杂志

ABSTRACT

Objective To investigate the typing, staging and therapeutic outcome of intrahepatic cholan-giocarcinoma (ICC). Methods The clinical data of 60 ICC patients who were admitted to the Renji Hospital of Shanghai Jiaotong University from January 2000 to December 2008 were retrospectively analyzed. ICC was classi-fied according to the type and TNM staging proposed by the Liver Cancer Study Group of Japan (LCSGJ). The relationships between typing, staging, surgical procedures and therapeutic outcome were investigated, as well as the relationship between the LCSGJ staging system and UICC staging system. Results The 1-, 3-, and 5-year survivals of the 60 ICC patients were 44% (23/52), 19% (10/52) and 10% (5/52), respectively. The median survival time for patients with radical resection (n =30) , liver transplantation (n = 10), palliative surgery (n = 11) and exploratory laparotomy (n=9) were 13, 3, 3 and 1 months, respectively. The radical resection rates for mass-forming type, periductal-infiltrating type, intraductal growth type and mixed type were 23/31, 9/15, 5/6 and 3/8, respectively. There were significant relationships between tumor type, degree of differentiation and prog-nosis (χ2 = 8. 308, 10. 009, P < 0. 05), and between tumor type and lymph node metastasis (χ2 = 13. 261, 5.702, P <0.05). There was no significant difference in survival time between patients with different pathological types, but the prognosis of patients with mucinous adenocarcinoma was better than that in the other types, with a median survival time of 20months. The median survival time of patients in LCSGJ stage Ⅳ was 3. 0 months, which was significantly longer than that in UICC stage Ⅳ (χ2 =3. 877, P <0. 05). Tumor staging was intimately related to the macroscopic type χ2 =8.288, P <0. 05). Conclusions The prognosis of ICC is poor. The typing and staging of LCSGJ is concise and practical, which is helpful in guiding treatment and evaluating progno-sis. Surgical treatment should be applied to mucinous ICC, and liver transplantation is not recommended for the treatment of ICC.