Proposal for a new classification for perihilar cholangiocarcinoma based on tumour depth. BJS 2019; 106: 427-435.
Published: 24th January 2019
Authors: K. Shinohara, T. Ebata, Y. Shimoyama, M. Nakaguro, T. Mizuno, K. Matsuo et al.
The T system for distal cholangiocarcinoma has been revised from a layer‐based to a depth‐based approach in the current American Joint Committee on Cancer (AJCC) classification. In perihilar cholangiocarcinoma, tumour depth in the staging scheme has not yet been addressed. The aim of this study was to propose a new T system using measured tumour depth in perihilar cholangiocarcinoma.
Patients who underwent hepatectomy for perihilar cholangiocarcinoma between 2001 and 2014 were reviewed retrospectively. The vertical distance between the top of the tumour and deepest invasive cells was measured as invasive tumour thickness (ITT) by two independent pathologists. Log rank statistics were used to determine cut‐off points, and the concordance (C) index was used to assess survival discrimination of each T system.
ITT was measurable in all 440 patients, with a median value of 6·0 (range 0–45) mm. The median difference in ITT between observers was 0·6 (range 0–20) mm. Cut‐off points for prognosis were 1, 5 and 8 mm. Five‐year survival decreased with increasing ITT (P < 0·001): 67 per cent for ITT less than 1 mm (25 patients), 54·9 per cent for ITT 1 mm and over to less than 5 mm (138 patients), 43·4 per cent for ITT 5 mm and over to less than 8 mm (118 patients), and 32·2 per cent for ITT 8 mm and over (159 patients). The C‐index of this classification was comparable to that of the current AJCC T classification (0·598 versus 0·589).
ITT is a reliable approach for making a depth assessment in perihilar cholangiocarcinoma. A four‐tier ITT classification with cut‐off points of 1, 5 and 8 mm is an adequate alternative to the current layer‐based T classification.Full text
You may also be interested in
Management of isolated recurrence after surgery for pancreatic adenocarcinoma. BJS 2019; 106: 898-909.
Authors: Y. I. Kim, K. B. Song, Y.‐J. Lee, K.‐M. Park, D. W. Hwang, J. H. Lee et al.
Costs and quality of life in a randomized trial comparing minimally invasive and open distal pancreatectomy (LEOPARD trial). BJS 2019; 106: 910-921.
Authors: J. van Hilst, E. A. Strating, T. de Rooij, F. Daams, S. Festen, B. Groot Koerkamp et al.
Authors: N. Takemura, T. Aoki, K. Hasegawa, J. Kaneko, J. Arita, N. Akamatsu et al.
Clinical value of additional resection of a margin‐positive distal bile duct in perihilar cholangiocarcinoma. BJS 2019; 106: 774-782.
Authors: S. Otsuka, T. Ebata, Y. Yokoyama, T. Mizuno, T. Tsukahara, Y. Shimoyama et al.
Authors: W. S. Tummers, J. V. Groen, B. G. Sibinga Mulder, A. Farina‐Sarasqueta, J. Morreau, H. Putter et al.
Multicentre study of multidisciplinary team assessment of pancreatic cancer resectability and treatment allocation. BJS 2019; 106: 756-764.
Authors: J. Kirkegård, E. K. Aahlin, M. Al‐Saiddi, S. O. Bratlie, M. Coolsen, R. J. de Haas et al.
Outcomes following pancreatic surgery using three different thromboprophylaxis regimens. BJS 2019; 106: 765-773.
Authors: R. G. Hanna‐Sawires, J. V. Groen, F. A. Klok, R. A. E. M. Tollenaar, W. E. Mesker, R. J. Swijnenburg et al.
Major hepatectomy with or without pancreatoduodenectomy for advanced gallbladder cancer. BJS 2019; 106: 626-635.
Authors: T. Mizuno, T. Ebata, Y. Yokoyama, T. Igami, J. Yamaguchi, S. Onoe et al.
Systematic review of clinical prediction models for survival after surgery for resectable pancreatic cancer. BJS 2019; 106: 342-354.
Authors: M. Strijker, J. W. Chen, T. H. Mungroop, N. B. Jamieson, C. H. van Eijck, E. W. Steyerberg et al.
Randomized clinical trial
Randomized trial of oral versus enteral feeding for patients with postoperative pancreatic fistula after pancreatoduodenectomy. BJS 2019; 106: 190-198.
Authors: J.‐M. Wu, T.‐C. Kuo, H.‐A. Chen, C.‐H. Wu, S.‐R. Lai, C.‐Y. Yang et al.
Clinical and experimental studies of intraperitoneal lipolysis and the development of clinically relevant pancreatic fistula after pancreatic surgery. BJS 2019; 106: 616-625.
Authors: Y. Uchida, T. Masui, K. Nakano, A. Yogo, A. Sato, K. Nagai et al.
Multicentre propensity score‐matched study of laparoscopic versus open repeat liver resection for colorectal liver metastases. BJS 2019; 106: 783-789.
Authors: M. J. van der Poel, L. Barkhatov, D. Fuks, G. Berardi, F. Cipriani, A. Aljaiuossi et al.