Staging of intrahepatic cholangiocarcinoma
Staging of intrahepatic cholangiocarcinoma
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DOI：
10.1097/mog.0b013e328337c899
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发表时间：
2010-05-01
影响因子：
2.5
通讯作者：
Pawlik, Timothy M.
中科院分区：
文献类型：
--
作者：
Nathan, Hari;Pawlik, Timothy M.
综述的目的肝内胆管细胞癌(ICC)的分期在历史上反映了肝细胞癌的分期，这主要是由于ICC是一种罕见的疾病。这篇综述总结了与ICC预后相关的最新进展，这使得针对这种疾病的独特的西方分期系统的发展成为可能。最近的发现一项大型癌症登记研究集中于确定ICC切除后的预后因素，目的是为ICC开发一种独特的分期系统。基于这一分析和来自较小机构系列的确证数据，美国癌症联合委员会(AJCC)第7版分期手册包括一个独特的ICC分期系统，重点关注多发性肿瘤、血管侵犯和淋巴转移。该系统比AJCC第6版分期更简单，但保留了预后区分；新系统也明显优于日本的分期系统。有证据表明，肿瘤累及的淋巴结数目可能影响预后。切缘阴性切除是决定ICC预后的主要治疗因素，除非存在远处转移，否则应继续进行。总结第一次，AJCC采用了明确的ICC分期系统。对肝细胞癌预后因素的了解仍不完全，但正在改善。这一领域正在发展中，随着关于这种日益常见的恶性肿瘤的更多数据的出现，对ICC的分期可能会进一步完善。
Purpose of reviewStaging of intrahepatic cholangiocarcinoma (ICC) has historically mirrored that for hepatocellular carcinoma, largely due to the fact that ICC has been an uncommon disease. This review summarizes recent developments related to prognostication in ICC that have allowed the development of a distinct Western staging system for this disease.Recent findingsA large cancer registry study focused on identification of prognostic factors after resection of ICC with the aim of developing a distinct staging system for ICC. On the basis of this analysis and corroborative data from smaller institutional series, the American Joint Committee on Cancer (AJCC) 7th edition staging manual includes a distinct staging system for ICC that focuses on multiple tumors, vascular invasion, and lymph node metastasis. This system is simpler than the AJCC 6th edition staging yet preserves prognostic discrimination; the new system is also significantly superior to the Japanese staging system. Some evidence suggests that the number of lymph nodes involved by tumor may influence prognosis. Margin-negative resection is a major therapeutic determinant of outcome in ICC and should be pursued unless distant metastasis is present.SummaryFor the first time, a distinct staging system for ICC has been adopted by the AJCC. Understanding of prognostic factors in ICC remains incomplete but is improving. This field is in evolution, and further refinements to the staging of ICC are likely as more data emerge on this increasingly common malignancy.