Surgical treatment of 32 patients with peripheral intrahepatic cholangiocarcinoma

L. E. Harrison, Y. Fong, D. S. Klimstra, S. Y. Zee, L. H. Blumgart

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Abstract

Background: Peripheral intrahepatic cholangiocarcinoma (PIG) is an intrahepatic primary liver neoplasm which is clinicopathologically distinct from hepatocellular carcinoma and major duct cholangiocarcinoma. The clinical outcome after resection of these rare tumours is not well documented. Methods: Review of the hepatic database and tumour registry at Memorial Sloan-Kettering Cancer Center identified 32 cases of PIC resected for cure over a 23-year period. Intrahepatic cholangiocarcinomas with major bile duct involvement were excluded from this analysis. Demographics, pathological features, biochemical markers, operative results and survival were analysed. Results: The majority of patients presented with abdominal pain (n = 19). Only two patients had pathological evidence of hepatic cirrhosis. Serum marker levels included α-fetoprotein (AFP; median 3.7 (range 0-225) ng/ml) and carcinoembryonic antigen (CEA; median 1.6 (range 0-30) ng/ ml). Type of hepatic resection included: wedge (n = 2), lobectomy (n = 14) and extended lobectomy (n = 16). There was one postoperative death. Median follow-up time was 27 months. Median survival was 59 months with an actuarial 5-year survival of 42 per cent. Vascular invasion and intrahepatic satellite lesions were predictors of worse survival (P < 0.05). Conclusion: PIC is a rare hepatic primary tumour, which usually presents in non-cirrhotic livers with a normal serum AFP and CEA level. In selected patients, complete surgical resection can be performed safely and is associated with long-term survival.

Original languageEnglish (US)
Pages (from-to)1068-1070
Number of pages3
JournalBritish Journal of Surgery
Volume85
Issue number8
DOIs
StatePublished - Aug 15 1998
Externally publishedYes

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Cholangiocarcinoma
Survival
Liver
Neoplasms
Biomarkers
Fetal Proteins
Therapeutics
Carcinoembryonic Antigen
Liver Neoplasms
Bile Ducts
Liver Cirrhosis
Abdominal Pain
Blood Vessels
Registries
Hepatocellular Carcinoma
Demography
Databases
Serum

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Harrison, L. E. ; Fong, Y. ; Klimstra, D. S. ; Zee, S. Y. ; Blumgart, L. H. / Surgical treatment of 32 patients with peripheral intrahepatic cholangiocarcinoma. In: British Journal of Surgery. 1998 ; Vol. 85, No. 8. pp. 1068-1070.
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abstract = "Background: Peripheral intrahepatic cholangiocarcinoma (PIG) is an intrahepatic primary liver neoplasm which is clinicopathologically distinct from hepatocellular carcinoma and major duct cholangiocarcinoma. The clinical outcome after resection of these rare tumours is not well documented. Methods: Review of the hepatic database and tumour registry at Memorial Sloan-Kettering Cancer Center identified 32 cases of PIC resected for cure over a 23-year period. Intrahepatic cholangiocarcinomas with major bile duct involvement were excluded from this analysis. Demographics, pathological features, biochemical markers, operative results and survival were analysed. Results: The majority of patients presented with abdominal pain (n = 19). Only two patients had pathological evidence of hepatic cirrhosis. Serum marker levels included α-fetoprotein (AFP; median 3.7 (range 0-225) ng/ml) and carcinoembryonic antigen (CEA; median 1.6 (range 0-30) ng/ ml). Type of hepatic resection included: wedge (n = 2), lobectomy (n = 14) and extended lobectomy (n = 16). There was one postoperative death. Median follow-up time was 27 months. Median survival was 59 months with an actuarial 5-year survival of 42 per cent. Vascular invasion and intrahepatic satellite lesions were predictors of worse survival (P < 0.05). Conclusion: PIC is a rare hepatic primary tumour, which usually presents in non-cirrhotic livers with a normal serum AFP and CEA level. In selected patients, complete surgical resection can be performed safely and is associated with long-term survival.",
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Surgical treatment of 32 patients with peripheral intrahepatic cholangiocarcinoma. / Harrison, L. E.; Fong, Y.; Klimstra, D. S.; Zee, S. Y.; Blumgart, L. H.

In: British Journal of Surgery, Vol. 85, No. 8, 15.08.1998, p. 1068-1070.

Research output: Contribution to journalArticle

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T1 - Surgical treatment of 32 patients with peripheral intrahepatic cholangiocarcinoma

AU - Harrison, L. E.

AU - Fong, Y.

AU - Klimstra, D. S.

AU - Zee, S. Y.

AU - Blumgart, L. H.

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N2 - Background: Peripheral intrahepatic cholangiocarcinoma (PIG) is an intrahepatic primary liver neoplasm which is clinicopathologically distinct from hepatocellular carcinoma and major duct cholangiocarcinoma. The clinical outcome after resection of these rare tumours is not well documented. Methods: Review of the hepatic database and tumour registry at Memorial Sloan-Kettering Cancer Center identified 32 cases of PIC resected for cure over a 23-year period. Intrahepatic cholangiocarcinomas with major bile duct involvement were excluded from this analysis. Demographics, pathological features, biochemical markers, operative results and survival were analysed. Results: The majority of patients presented with abdominal pain (n = 19). Only two patients had pathological evidence of hepatic cirrhosis. Serum marker levels included α-fetoprotein (AFP; median 3.7 (range 0-225) ng/ml) and carcinoembryonic antigen (CEA; median 1.6 (range 0-30) ng/ ml). Type of hepatic resection included: wedge (n = 2), lobectomy (n = 14) and extended lobectomy (n = 16). There was one postoperative death. Median follow-up time was 27 months. Median survival was 59 months with an actuarial 5-year survival of 42 per cent. Vascular invasion and intrahepatic satellite lesions were predictors of worse survival (P < 0.05). Conclusion: PIC is a rare hepatic primary tumour, which usually presents in non-cirrhotic livers with a normal serum AFP and CEA level. In selected patients, complete surgical resection can be performed safely and is associated with long-term survival.

AB - Background: Peripheral intrahepatic cholangiocarcinoma (PIG) is an intrahepatic primary liver neoplasm which is clinicopathologically distinct from hepatocellular carcinoma and major duct cholangiocarcinoma. The clinical outcome after resection of these rare tumours is not well documented. Methods: Review of the hepatic database and tumour registry at Memorial Sloan-Kettering Cancer Center identified 32 cases of PIC resected for cure over a 23-year period. Intrahepatic cholangiocarcinomas with major bile duct involvement were excluded from this analysis. Demographics, pathological features, biochemical markers, operative results and survival were analysed. Results: The majority of patients presented with abdominal pain (n = 19). Only two patients had pathological evidence of hepatic cirrhosis. Serum marker levels included α-fetoprotein (AFP; median 3.7 (range 0-225) ng/ml) and carcinoembryonic antigen (CEA; median 1.6 (range 0-30) ng/ ml). Type of hepatic resection included: wedge (n = 2), lobectomy (n = 14) and extended lobectomy (n = 16). There was one postoperative death. Median follow-up time was 27 months. Median survival was 59 months with an actuarial 5-year survival of 42 per cent. Vascular invasion and intrahepatic satellite lesions were predictors of worse survival (P < 0.05). Conclusion: PIC is a rare hepatic primary tumour, which usually presents in non-cirrhotic livers with a normal serum AFP and CEA level. In selected patients, complete surgical resection can be performed safely and is associated with long-term survival.

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