Classification of Intrahepatic Cholangiocarcinoma into Perihilar Versus Peripheral Subtype

Background Intrahepatic cholangiocarcinoma (ICC) constitutes a group of heterogeneous malignancies within the liver. We sought to subtype ICC based on anatomical origin of tumors, as well as propose modifications of the current classification system. Methods Patients undergoing curative-intent resec...

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Bibliographic Details
Published in:Annals of surgical oncology 2024-02, Vol.31 (2), p.1232-1242
Main Authors: Wei, Tao, Lu, Jianfeng, Xiao, Xue-Lian, Weiss, Matthew, Popescu, Irinel, Marques, Hugo P., Aldrighetti, Luca, Maithel, Shishir K., Pulitano, Carlo, Bauer, Todd W., Shen, Feng, Poultsides, George A., Soubrane, Oliver, Martel, Guillaume, Koerkamp, Bas Groot, Itaru, Endo, Lv, Yi, Zhang, Xu-Feng, Pawlik, Timothy M.
Format: Article
Language:English
Subjects:
Bile Duct Neoplasms - pathology
Bile ducts
Bile Ducts, Intrahepatic - pathology
Carcinoma, Hepatocellular - surgery
Cholangiocarcinoma
Cholangiocarcinoma - pathology
Classification
Hepatobiliary Tumors
Hepatocellular carcinoma
Humans
Liver
Liver cancer
Liver Neoplasms - pathology
Malignancy
Medical prognosis
Medicine
Medicine & Public Health
Metastases
Microvasculature
Oncology
Prognosis
Surgery
Surgical Oncology
Survival
Tumors
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Summary:Background Intrahepatic cholangiocarcinoma (ICC) constitutes a group of heterogeneous malignancies within the liver. We sought to subtype ICC based on anatomical origin of tumors, as well as propose modifications of the current classification system. Methods Patients undergoing curative-intent resection for ICC, hilar cholangiocarcinoma (CCA), or hepatocellular carcinoma (HCC) were identified from three international multi-institutional consortia of databases. Clinicopathological characteristics and survival outcomes were assessed. Results Among 1264 patients with ICC, 1066 (84.3%) were classified as ICC-peripheral subtype, whereas 198 (15.7%) were categorized as ICC-perihilar subtype. Compared with ICC-peripheral subtype, ICC-perihilar subtype was more often associated with aggressive tumor characteristics, including a higher incidence of nodal metastasis, macro- and microvascular invasion, perineural invasion, as well as worse overall survival (OS) (median: ICC-perihilar 19.8 vs. ICC-peripheral 37.1 months; p  
ISSN:1068-9265
1534-4681
DOI:10.1245/s10434-023-14502-3