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Tumor Size Predicts Vascular Invasion and Histologic Grade Among Patients Undergoing Resection of Intrahepatic Cholangiocarcinoma |
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| Authors: | Gaya Spolverato Aslam Ejaz Yuhree Kim Georgios C. Sotiropoulos Andreas Pau Sorin Alexandrescu Hugo Marques Carlo Pulitano Eduardo Barroso Bryan M. Clary Luca Aldrighetti Todd W. Bauer Dustin M. Walters Ryan Groeschl T. Clark Gamblin Wallis Marsh Kevin T. Nguyen Ryan Turley Irinel Popescu Catherine Hubert Stephanie Meyer Jean-Francois Gigot Gilles Mentha Timothy M. Pawlik |
| Affiliation: | 1. Department of Surgery at Johns Hopkins University School of Medicine, Baltimore, MD, USA 2. University Hospital Essen, Essen, Germany 3. Institute for Digestive Diseases and Liver Transplantation Fundeni, Bucharest, Romania 4. Curry Cabral Hospital, Lisbon, Portugal 5. Ospedale San Raffaele, Milan, Italy 6. Duke Medical Center, Durham, NC, USA 7. University of Virginia, Charlottesville, VA, USA 8. Medical College of Wisconsin, Milwaukee, WI, USA 9. University of Pittsburgh, Pittsburgh, PA, USA 10. Cliniques Universitaires Saint-Luc, Brussels, Belgium 11. H?pitaux Universitaires de Genève, Geneva, Switzerland 12. Department of Surgery, Johns Hopkins Hospital, 600N. Wolfe Street, Blalock 688, Baltimore, MD, 21287, USA |
| Abstract: | The association between tumor size and survival in patients with intrahepatic cholangiocarcinoma (ICC) undergoing surgical resection is controversial. We sought to define the incidence of major and microscopic vascular invasion relative to ICC tumor size, and identify predictors of microscopic vascular invasion in patients with ICC ≥5 cm. A total of 443 patients undergoing surgical resection for ICC between 1973 and 2011 at one of 11 participating institutions were identified. Clinical and pathologic data were evaluated using uni- and multivariate analyses. As tumor sized increased, the incidence of microscopic vascular invasion increased: <3 cm, 3.6 %; 3–5 cm, 24.7 %; 5–7 cm, 38.3 %; 7–15 cm, 32.9 %, ≥15 cm, 55.6 %; (p?15 cm, 31.6 % (p?=?0.04). The presence of perineural invasion (odds ratio [OR]?=?2.98) and regional lymph node metastasis (OR?=?4.43) were independently associated with an increased risk of microscopic vascular invasion in tumors ≥5 cm (both p? |
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