BACKGROUND The objective of the current study was to develop a model to predict the likelihood of occult lymph node metastasis (LNM) prior to resection of intrahepatic cholangiocarcinoma (ICC). METHODS Patients who underwent hepatectomy for ICC between 2000 and 2017 were identified using a multi-institutional database. A novel model incorporating clinical and preoperative imaging data was developed to predict LNM. RESULTS Among 980 patients who underwent resection of ICC, 190 (19.4%) individuals had at least one LNM identified on final pathology. An enhanced imaging model incorporating clinical and imaging data was developed to predict LNM ( https://k-sahara.shinyapps.io/ICC_imaging/ ). The performance of the enhanced imaging model was very good in the training data set (c-index 0.702), as well as the validation data set with bootstrapping resamples (c-index 0.701) and outperformed the preoperative imaging alone (c-index 0.660). The novel model predicted both 5-year overall survival (OS) (low risk 48.4% vs. high risk 18.4%) and 5-year disease-specific survival (DSS) (low risk 51.9% vs. high risk 25.2%, both p 0.05). CONCLUSION This tool may represent an opportunity to stratify prognosis of Nx patients and can help inform clinical decision-making prior to resection of ICC.
Background Accurate risk stratification and patient selection is necessary to identify patients who will benefit the most from surgery or be better treated with other non-surgical treatment strategies. We sought to identify which patients in the preoperative setting would likely derive the most or least benefit from resection of intrahepatic cholangiocarcinoma (ICC).
Objectives:To determine the prognostic implication of the number and station of LNM, and the minimal number of LNs needed for evaluation to accurately stage patients with intrahepatic cholangiocarcinoma (ICC).Background:Impact of the number and station of LNM on long-term survival, and the minimal n
#2J. Madison Hyer(The Ohio State University Wexner Medical Center)H-Index: 16
Last. Timothy M. Pawlik(The Ohio State University Wexner Medical Center)H-Index: 118
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Background: The objective of the current study was to define the impact of albumin-bilirubin (ALBI) grade on short- as well as long-term outcomes among patients with intrahepatic cholangiocarcinoma (ICC). Methods: Patients who underwent hepatectomy for ICC between 1990 and 2016 were identified using an international multi-institutional database. Clinicopathologic factors including ALBI score were assessed using bivariate and multivariable analyses, as well as standard survival analyses. Results:...
Last. Timothy M. Pawlik(The Ohio State University Wexner Medical Center)H-Index: 118
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Introduction Intrahepatic cholangiocarcinoma (ICC) remains an uncommon disease with a rising incidence worldwide. We sought to identify trends in therapeutic approaches and differences in patient outcomes based on facility types.
Last. Timothy M. Pawlik(The Ohio State University Wexner Medical Center)H-Index: 118
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Background Although lymph node metastasis (LNM) is an important prognostic indicator for patients with intrahepatic cholangiocarcinoma (ICC), the benefit and indication for lymphadenectomy remain unclear.
#2Fei-Peng Zhu(Nanjing Medical University)H-Index: 5
Last. Xue-Hao Wang(Nanjing Medical University)H-Index: 6
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Objectives This study was conducted in order to establish and validate a radiomics model for predicting lymph node (LN) metastasis of intrahepatic cholangiocarcinoma (IHC) and to determine its prognostic value.
#2Richard Fox(University of Birmingham)H-Index: 12
Last. John Bridgewater(UCL: University College London)H-Index: 42
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BACKGROUND Despite improvements in multidisciplinary management, patients with biliary tract cancer have a poor outcome. Only 20% of patients are eligible for surgical resection with curative intent, with 5-year overall survival of less than 10% for all patients. To our knowledge, no studies have described a benefit of adjuvant therapy. We aimed to determine whether adjuvant capecitabine improved overall survival compared with observation following surgery for biliary tract cancer. METHODS This ...
Last. Timothy M. Pawlik(The Ohio State University Wexner Medical Center)H-Index: 118
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Objective We sought to evaluate the utilization of lymphadenectomy (LND) and the incidence of lymph node metastasis (LNM) among different morphologic types of intrahepatic cholangiocarcinoma (ICC).
For intrahepatic and perihilar cholangiocarcinoma (CC), up-to-date imaging techniques and multimodality multiparametric imaging approaches can improve diagnostic accuracy for tumor staging and resectability assessment. Current concepts regarding risk factors, cholangiocarcinogenesis, and premalignant tumors may also allow a better understanding of the tumor biology and imaging features of CC.
#1Farhan Z. Ilyas(The Ohio State University Wexner Medical Center)
#2Joal D. Beane(The Ohio State University Wexner Medical Center)H-Index: 20
Last. Timothy M. Pawlik(The Ohio State University Wexner Medical Center)H-Index: 118
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Hepatobiliary cancers, including hepatocellular carcinoma (HCC), cholangiocarcinoma (CCA), and gallbladder carcinoma (GBC), are lethal cancers with limited therapeutic options. Curative-intent treatment typically involves surgery, yet recurrence is common and many patients present with advanced disease not amenable to an operation. Immunotherapy represents a promising approach to improve outcomes, but the immunosuppressive tumor microenvironment of the liver characteristic of hepatobiliary cance...
#2Kevin C. Soares(MSK: Memorial Sloan Kettering Cancer Center)H-Index: 3
#3Kenneth Seier(MSK: Memorial Sloan Kettering Cancer Center)H-Index: 10
Last. William R. Jarnagin(MSK: Memorial Sloan Kettering Cancer Center)H-Index: 123
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Background: Lymph node metastasis (LNM) drastically reduces survival after resection of intrahepatic cholangiocarcinoma (IHC). Optimal treatment is ill-defined, and it is unclear if tumor mutational profiling can support treatment decisions. Methods: Patients with liver-limited IHC with or without LNM treated with resection (N=237), hepatic arterial infusion chemotherapy (HAIC) (N=196), or systemic chemotherapy alone (SYS) (N=140) at our institution between 2000-2018 were included. Genomic seque...
