A Proposed Staging System for Intrahepatic Cholangiocarcinoma

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dc.contributor.author Nathan, Hari
dc.contributor.author Aloia, Thomas
dc.contributor.author Vauthey, Jean-Nicolas
dc.contributor.author Abdalla, Eddie
dc.contributor.author Zhu, Andrew
dc.contributor.author Schulick, Richard
dc.contributor.author Choti, Micheal
dc.contributor.author Pawlik, Timothy
dc.date.accessioned 2015-11-18T06:44:53Z
dc.date.available 2015-11-18T06:44:53Z
dc.date.copyright 2009
dc.date.issued 2015-11-18
dc.identifier.issn 1068-9265 en_US
dc.identifier.uri http://hdl.handle.net/10725/2603
dc.description.abstract The American Joint Committee on Cancer (AJCC)/International Union Against Cancer (UICC) staging system for liver cancer is based on data exclusively derived from hepatocellular carcinoma (HCC) patients and thus may be inappropriate for patients with intrahepatic cholangiocarcinoma (ICC). We sought to empirically derive an ICC staging system from population-based data on patients with ICC. The Surveillance, Epidemiology, and End Results (SEER) database was used to identify 598 patients who underwent surgery for ICC between 1988 and 2004. The discriminative abilities of the AJCC/UICC liver cancer and two Japanese ICC staging systems were evaluated. Independent predictors of survival were identified using Cox proportional hazards models. A staging system for ICC was then derived based on these analyses. The AJCC/UICC T classification system failed to adequately stratify the T2 and T3 cohorts due to tumor size >5 cm not being a relevant prognostic factor [hazard ratio (HR) 0.97, 95% confidence interval (CI) 0.72–1.30]. In contrast, presence of multiple lesions (HR 1.42, 95% CI 1.01–2.01) or vascular invasion (HR 1.53, 95% CI 1.10–2.12) predicted adverse prognosis. Based on these findings, an ICC staging system was developed that omits tumor size. This system showed no loss of prognostic discrimination compared with the AJCC/UICC system and significant superiority over the Japanese systems. We conclude that the AJCC/UICC liver cancer staging system fails to stratify ICC patients adequately and inappropriately includes tumor size. We propose a staging system specifically developed for ICC based on number of tumors, vascular invasion, lymph node status, and presence of metastatic disease. en_US
dc.language.iso en en_US
dc.title A Proposed Staging System for Intrahepatic Cholangiocarcinoma en_US
dc.type Article en_US
dc.description.version Published en_US
dc.author.school SOM en_US
dc.author.idnumber 201100945 en_US
dc.author.woa N/A en_US
dc.author.department N/A en_US
dc.description.embargo N/A en_US
dc.relation.journal Annals of Surgical Oncology en_US
dc.journal.volume 16 en_US
dc.journal.issue 1 en_US
dc.article.pages 14-22 en_US
dc.identifier.doi http://dx.doi.org/10.1245/s10434-008-0180-z en_US
dc.identifier.ctation Nathan, H., Aloia, T. A., Vauthey, J. N., Abdalla, E. K., Zhu, A. X., Schulick, R. D., ... & Pawlik, T. M. (2009). A proposed staging system for intrahepatic cholangiocarcinoma. Annals of surgical oncology, 16(1), 14-22. en_US
dc.author.email eddie.abdalla@lau.edu.lb
dc.identifier.url http://link.springer.com/article/10.1245/s10434-008-0180-z

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