TY - JOUR
T1 - Management of biliary cystic tumors
T2 - A multi-institutional analysis of a rare liver tumor
AU - Arnaoutakis, Dean J.
AU - Kim, Yuhree
AU - Pulitano, Carlo
AU - Zaydfudim, Victor
AU - Squires, Malcolm H.
AU - Kooby, David
AU - Groeschl, Ryan
AU - Alexandrescu, Sorin
AU - Bauer, Todd W.
AU - Bloomston, Mark
AU - Soares, Kevin
AU - Marques, Hugo
AU - Clark Gamblin, T.
AU - Popescu, Irinel
AU - Adams, Reid
AU - Nagorney, David
AU - Barroso, Eduardo
AU - Maithel, Shishir K.
AU - Crawford, Michael
AU - Sandroussi, Charbel
AU - Marsh, Wallis
AU - Pawlik, Timothy M.
PY - 2015
Y1 - 2015
N2 - Objective: To characterize clinical and radiological features associated with biliary cystic tumors (BCTs) of the liver, and to define recurrence-free and overall survival. Background: Biliary cystadenoma (BCA) and biliary cystadenocarcinoma (BCAC) are rare tumors that arise in the liver. Methods: Between 1984 and 2013, 248 patients who underwent surgical resection of BCA or BCAC were identified. Clinical and outcome data were analyzed. Results: Median total bilirubin, CA19-9, and carcinoembryonic antigen (CEA) levels were 0.6 mg/dL, 15.0 U/mL, and 2.7 ng/mL, respectively. Preoperative imaging included computed tomography only (62.5%), magnetic resonance imaging only (6.9%), or CT + MRI (18.5%). Features on cross-sectional imaging included multiloculation (56.9%), mural nodularity (16.5%), and biliary ductal dilatation (17.7%). The presence of these factors did not reliably predict BCAC versus BCA (sensitivity, 81%; specificity, 21%). Median biliary cyst size was 10.0 cm(interquartile range, 7-13 cm). Operative interventions included unroofing/partial excision of the lesion (14.1%), less than hemihepatectomy (48.8%), or hemi-/extended hepatectomy (36.3%). On pathology most lesions were BCA (89.1%), whereas 27 (10.9%) were BCAC. At last follow-up, there were 46 (18.3%) recurrences; 2 patients who initially had BCA recurred with BCAC. Median overall survival was 18.1 years; 1-year, 3-year, and 5-year survival was 95.0%, 86.8%, and 84.2%, respectively. Long-term outcomes were associated with BCAC versus BCA, as well as the presence of spindle cell/ovarian stroma (both P
AB - Objective: To characterize clinical and radiological features associated with biliary cystic tumors (BCTs) of the liver, and to define recurrence-free and overall survival. Background: Biliary cystadenoma (BCA) and biliary cystadenocarcinoma (BCAC) are rare tumors that arise in the liver. Methods: Between 1984 and 2013, 248 patients who underwent surgical resection of BCA or BCAC were identified. Clinical and outcome data were analyzed. Results: Median total bilirubin, CA19-9, and carcinoembryonic antigen (CEA) levels were 0.6 mg/dL, 15.0 U/mL, and 2.7 ng/mL, respectively. Preoperative imaging included computed tomography only (62.5%), magnetic resonance imaging only (6.9%), or CT + MRI (18.5%). Features on cross-sectional imaging included multiloculation (56.9%), mural nodularity (16.5%), and biliary ductal dilatation (17.7%). The presence of these factors did not reliably predict BCAC versus BCA (sensitivity, 81%; specificity, 21%). Median biliary cyst size was 10.0 cm(interquartile range, 7-13 cm). Operative interventions included unroofing/partial excision of the lesion (14.1%), less than hemihepatectomy (48.8%), or hemi-/extended hepatectomy (36.3%). On pathology most lesions were BCA (89.1%), whereas 27 (10.9%) were BCAC. At last follow-up, there were 46 (18.3%) recurrences; 2 patients who initially had BCA recurred with BCAC. Median overall survival was 18.1 years; 1-year, 3-year, and 5-year survival was 95.0%, 86.8%, and 84.2%, respectively. Long-term outcomes were associated with BCAC versus BCA, as well as the presence of spindle cell/ovarian stroma (both P
KW - Biliary cystadenocarcinoma
KW - Biliary cystadenoma
KW - Cyst
KW - Liver
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UR - http://www.scopus.com/inward/citedby.url?scp=84926950822&partnerID=8YFLogxK
U2 - 10.1097/SLA.0000000000000543
DO - 10.1097/SLA.0000000000000543
M3 - Article
C2 - 24509187
AN - SCOPUS:84926950822
VL - 261
SP - 361
EP - 367
JO - Annals of Surgery
JF - Annals of Surgery
SN - 0003-4932
IS - 2
ER -