Tumor Size Predicts Vascular Invasion and Histologic Grade Among Patients Undergoing Resection of Intrahepatic Cholangiocarcinoma

Gaya Spolverato, Aslam Ejaz, Yuhree Kim, Georgios C. Sotiropoulos, Andreas Pau, Sorin Alexandrescu, Hugo Marques, Carlo Pulitano, Eduardo Barroso, Bryan M. Clary, Luca Aldrighetti, Todd W. Bauer, Dustin M. Walters, Ryan Groeschl, T. Clark Gamblin, Wallis Marsh, Kevin T. Nguyen, Ryan Turley, Irinel Popescu, Catherine HubertStephanie Meyer, Jean Francois Gigot, Gilles Mentha, Timothy M. Pawlik

Research output: Contribution to journalArticle

Abstract

The association between tumor size and survival in patients with intrahepatic cholangiocarcinoma (ICC) undergoing surgical resection is controversial. We sought to define the incidence of major and microscopic vascular invasion relative to ICC tumor size, and identify predictors of microscopic vascular invasion in patients with ICC ≥5 cm. A total of 443 patients undergoing surgical resection for ICC between 1973 and 2011 at one of 11 participating institutions were identified. Clinical and pathologic data were evaluated using uni- and multivariate analyses. As tumor sized increased, the incidence of microscopic vascular invasion increased: 15 cm, 31.6 % (p = 0.04). The presence of perineural invasion (odds ratio [OR] = 2.98) and regional lymph node metastasis (OR = 4.43) were independently associated with an increased risk of microscopic vascular invasion in tumors ≥5 cm (both p <0.05). Risk of microscopic vascular invasion and worse tumor grade increased with tumor size. Large tumors likely harbor worse pathologic features; this information should be considered when determining therapy and prognosis of patients with large ICC.

Original languageEnglish (US)
Pages (from-to)1284-1291
Number of pages8
JournalJournal of Gastrointestinal Surgery
Volume18
Issue number7
DOIs
StatePublished - 2014

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Cholangiocarcinoma
Blood Vessels
Neoplasms
Odds Ratio
Incidence
Multivariate Analysis
Lymph Nodes
Neoplasm Metastasis
Survival

Keywords

  • Intrahepatic cholangiocarcinoma
  • Tumor size
  • Vascular invasion

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology
  • Medicine(all)

Cite this

Tumor Size Predicts Vascular Invasion and Histologic Grade Among Patients Undergoing Resection of Intrahepatic Cholangiocarcinoma. / Spolverato, Gaya; Ejaz, Aslam; Kim, Yuhree; Sotiropoulos, Georgios C.; Pau, Andreas; Alexandrescu, Sorin; Marques, Hugo; Pulitano, Carlo; Barroso, Eduardo; Clary, Bryan M.; Aldrighetti, Luca; Bauer, Todd W.; Walters, Dustin M.; Groeschl, Ryan; Gamblin, T. Clark; Marsh, Wallis; Nguyen, Kevin T.; Turley, Ryan; Popescu, Irinel; Hubert, Catherine; Meyer, Stephanie; Gigot, Jean Francois; Mentha, Gilles; Pawlik, Timothy M.

In: Journal of Gastrointestinal Surgery, Vol. 18, No. 7, 2014, p. 1284-1291.

Research output: Contribution to journalArticle

Spolverato, G, Ejaz, A, Kim, Y, Sotiropoulos, GC, Pau, A, Alexandrescu, S, Marques, H, Pulitano, C, Barroso, E, Clary, BM, Aldrighetti, L, Bauer, TW, Walters, DM, Groeschl, R, Gamblin, TC, Marsh, W, Nguyen, KT, Turley, R, Popescu, I, Hubert, C, Meyer, S, Gigot, JF, Mentha, G & Pawlik, TM 2014, 'Tumor Size Predicts Vascular Invasion and Histologic Grade Among Patients Undergoing Resection of Intrahepatic Cholangiocarcinoma', Journal of Gastrointestinal Surgery, vol. 18, no. 7, pp. 1284-1291. https://doi.org/10.1007/s11605-014-2533-1
Spolverato, Gaya ; Ejaz, Aslam ; Kim, Yuhree ; Sotiropoulos, Georgios C. ; Pau, Andreas ; Alexandrescu, Sorin ; Marques, Hugo ; Pulitano, Carlo ; Barroso, Eduardo ; Clary, Bryan M. ; Aldrighetti, Luca ; Bauer, Todd W. ; Walters, Dustin M. ; Groeschl, Ryan ; Gamblin, T. Clark ; Marsh, Wallis ; Nguyen, Kevin T. ; Turley, Ryan ; Popescu, Irinel ; Hubert, Catherine ; Meyer, Stephanie ; Gigot, Jean Francois ; Mentha, Gilles ; Pawlik, Timothy M. / Tumor Size Predicts Vascular Invasion and Histologic Grade Among Patients Undergoing Resection of Intrahepatic Cholangiocarcinoma. In: Journal of Gastrointestinal Surgery. 2014 ; Vol. 18, No. 7. pp. 1284-1291.
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abstract = "The association between tumor size and survival in patients with intrahepatic cholangiocarcinoma (ICC) undergoing surgical resection is controversial. We sought to define the incidence of major and microscopic vascular invasion relative to ICC tumor size, and identify predictors of microscopic vascular invasion in patients with ICC ≥5 cm. A total of 443 patients undergoing surgical resection for ICC between 1973 and 2011 at one of 11 participating institutions were identified. Clinical and pathologic data were evaluated using uni- and multivariate analyses. As tumor sized increased, the incidence of microscopic vascular invasion increased: 15 cm, 31.6 {\%} (p = 0.04). The presence of perineural invasion (odds ratio [OR] = 2.98) and regional lymph node metastasis (OR = 4.43) were independently associated with an increased risk of microscopic vascular invasion in tumors ≥5 cm (both p <0.05). Risk of microscopic vascular invasion and worse tumor grade increased with tumor size. Large tumors likely harbor worse pathologic features; this information should be considered when determining therapy and prognosis of patients with large ICC.",
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AU - Spolverato, Gaya

AU - Ejaz, Aslam

AU - Kim, Yuhree

AU - Sotiropoulos, Georgios C.

AU - Pau, Andreas

AU - Alexandrescu, Sorin

AU - Marques, Hugo

AU - Pulitano, Carlo

AU - Barroso, Eduardo

AU - Clary, Bryan M.

AU - Aldrighetti, Luca

AU - Bauer, Todd W.

AU - Walters, Dustin M.

AU - Groeschl, Ryan

AU - Gamblin, T. Clark

AU - Marsh, Wallis

AU - Nguyen, Kevin T.

AU - Turley, Ryan

AU - Popescu, Irinel

AU - Hubert, Catherine

AU - Meyer, Stephanie

AU - Gigot, Jean Francois

AU - Mentha, Gilles

AU - Pawlik, Timothy M.

PY - 2014

Y1 - 2014

N2 - The association between tumor size and survival in patients with intrahepatic cholangiocarcinoma (ICC) undergoing surgical resection is controversial. We sought to define the incidence of major and microscopic vascular invasion relative to ICC tumor size, and identify predictors of microscopic vascular invasion in patients with ICC ≥5 cm. A total of 443 patients undergoing surgical resection for ICC between 1973 and 2011 at one of 11 participating institutions were identified. Clinical and pathologic data were evaluated using uni- and multivariate analyses. As tumor sized increased, the incidence of microscopic vascular invasion increased: 15 cm, 31.6 % (p = 0.04). The presence of perineural invasion (odds ratio [OR] = 2.98) and regional lymph node metastasis (OR = 4.43) were independently associated with an increased risk of microscopic vascular invasion in tumors ≥5 cm (both p <0.05). Risk of microscopic vascular invasion and worse tumor grade increased with tumor size. Large tumors likely harbor worse pathologic features; this information should be considered when determining therapy and prognosis of patients with large ICC.

AB - The association between tumor size and survival in patients with intrahepatic cholangiocarcinoma (ICC) undergoing surgical resection is controversial. We sought to define the incidence of major and microscopic vascular invasion relative to ICC tumor size, and identify predictors of microscopic vascular invasion in patients with ICC ≥5 cm. A total of 443 patients undergoing surgical resection for ICC between 1973 and 2011 at one of 11 participating institutions were identified. Clinical and pathologic data were evaluated using uni- and multivariate analyses. As tumor sized increased, the incidence of microscopic vascular invasion increased: 15 cm, 31.6 % (p = 0.04). The presence of perineural invasion (odds ratio [OR] = 2.98) and regional lymph node metastasis (OR = 4.43) were independently associated with an increased risk of microscopic vascular invasion in tumors ≥5 cm (both p <0.05). Risk of microscopic vascular invasion and worse tumor grade increased with tumor size. Large tumors likely harbor worse pathologic features; this information should be considered when determining therapy and prognosis of patients with large ICC.

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