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http://dx.doi.org/10.7314/APJCP.2012.13.2.725

Diagnosis and Cure Experience of Hepatolithiasis-Associated Intrahepatic Cholangiocarcinoma in 66 Patients  

Li, Hong-Yang (Department of Hepatobiliary Surgery, the Second Affiliated Hospital, Chongqing University of Medical Sciences)
Zhou, Shi-Ji (Department of Hepatobiliary Surgery, the Second Affiliated Hospital, Chongqing University of Medical Sciences)
Li, Min (Department of Hepatobiliary Surgery, the Second Affiliated Hospital, Chongqing University of Medical Sciences)
Xiong, Ding (Department of Hepatobiliary Surgery, the Second Affiliated Hospital, Chongqing University of Medical Sciences)
Singh, Akanand (Department of Hepatobiliary Surgery, the Second Affiliated Hospital, Chongqing University of Medical Sciences)
Guo, Qing-Xi (Department of Pathology, Luzhou Medical College)
Liu, Chang-An (Department of Hepatobiliary Surgery, the Second Affiliated Hospital, Chongqing University of Medical Sciences)
Gong, Jian-Ping (Department of Hepatobiliary Surgery, the Second Affiliated Hospital, Chongqing University of Medical Sciences)
Publication Information
Asian Pacific Journal of Cancer Prevention / v.13, no.2, 2012 , pp. 725-729 More about this Journal
Abstract
Background: The management of hepatolithiasis combined with intrahepatic cholangicarcinoma (IHHCC) remains a challenge due to poor prognosis. The aim of this study was to summarize our diagnosis and cure experience of IHHCC over the recent 10 years. Methods: From January 1996 to January 2006, 66 patients with IHHCC were reviewed retrospectively. Results: Of the 66 patients, 52 underwent surgical resection (radical resection in 38 and palliative in 14) and 8 patients abdominal exploration, while the other 6 cases received endoscopic retrograde biliary internal drainage and stent implantation. In this series, correct diagnosis of advanced stage was made during operation in 8 cases (8/60, 13.3%) and all of them (underwent unnecessary abdominal exploration, among them the positive rate of CA19-9 was 100%, and the positive rate of CEA was 87.6% (7/8), incidence rate of ascites was 100% and short-term significant weight loss was 100%, with median overall survival of only 4 months. Conclusion: Radical resection is mandatory for IHHCC patient to achieve long-term survival, the CT and MR imaging features of IHHCC being concentric enhancement. Patients with IHHCC have significant higher CA199 and significant higher CEA and short-term significant weight loss and ascites should be considered with advanced stage of IHHCC and unnecessary non-therapeutic laparotomies should be avoided.
Keywords
Intrahepatic cholangiocarcinoma; hepatolithiasis; diagnosis; therapy;
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1 Palmucci S, Mauro LA, CoppolinoM, et al (2010). Evaluation of the biliary and pancre-atic systemwith 2D SSFSE, breath-hold 3D FRFSE and respiratory-triggered 3DFRFSE sequences. Radio Med, 115, 467-82.   DOI
2 Patel T, Singh P (2007). Cholangiocarcinoma: emerging approaches toa challenging cancer. Curr Opin Gastroenterol, 23, 317-23.   DOI
3 Patt Yz Hassan MM.Lozano RD, et al (2001). Phase II trial of cisplatin,interferon alpha-2b,doxorubicin, and 5-fluorouracil for biliary tract cancer. Clin Cancer Res, 7, 3375-80.
4 Saness, MacCallum JD (1952). Primary carcinoma of the liver cholangiocarcinoma in hepatolithiasis. Am J pathol, 18, 675-9.
5 Schulick RD (2008). Primary sclerosing cholangitis: detection of cancer in strictures. J Gastrointest Surg, 12, 420-2.   DOI
6 Shaib YH, Davila JA, Henderson L, McGlynn KA, El-Serag HB (2007). Endoscopic and surgical therapy for intrahepatic cholangiocarcinoma in the united states: a population-based study. J Clin Gastroenterol, 41, 911-7.   DOI
7 Sodickson A, Mortele KJ, BarishMA, et al (2006). Threedimensional fast-recovery fastspin-echoMRCP: comparisonwith two-dimensional single-shot fast spin-echo techniques. Radiology, 238, 549-59.   DOI
8 Tanaka S, Yamamoto T, Tanaka H, et al (2005). Potentiality of combined hepatocellular and intrahepatic cholangiocellular carcinoma originating from a hepatic precursor cell: immunohistochemical evidence. Hepatol Res, 32, 52-7.   DOI
9 Tischoff I, Tannapfel A (2007). Hepatocellular carcinoma and cholangiocarcinoma-different prognosis, pathogenesis and therapy. Zentralbl Chir, 132, 300-5.   DOI
10 Chen MF, Jan YY, Hwang TL, Jeng LB, Yeh TS (2000). Impact of concomitant hepatolithiasis on patients with peripheral cholangiocarcinoma. Dig Dis Sci, 45, 312-6.   DOI
11 Chen YX, Zeng ZC, Tang ZY, et al (2010). Determining the role of external beam radiotherapy in unresectable intrahepatic cholangiocarcinoma: a retrospective analysis of 84 patients. BMC Cancer, 10, 492.   DOI
12 Choi JY, KimMJ, Lee JM, et al (2008). Magnetic resonance cholangiography: comparison of two- and three-dimensional sequences for assessment of malignant biliary obstruction. Eur Radiol, 18, 78-86.   DOI
13 Connor S, Barron E, Redhead DN, et al (2007). Palliation for suspected unresectable hilar cholangiocarcinoma. Eur J Surg Oncol, 33, 341-5.   DOI
14 Gaujoux S, Allen PJ (2010). Role of staging laparoscopy in peri-pancreatic and hepatobiliary malignancy. World J Gastrointest Surg, 2, 283-90.   DOI
15 Zhou YM, Yin ZF, Yang JM, et al (2008). Risk factors for intrahepatic cholangiocarcinoma: a case-control study in China. World J Gastroenterol, 14, 632-5.   DOI
16 Uenishi T, Yamazaki O, Yamamoto T, et al (2005). Serosal invasion in TNM staging of mass-forming intrahepatic cholangiocarcinoma. J Hepatobiliary Pancreat Surg, 12, 479-83.   DOI
17 Witzigmann H, Berr F, Ringel U, et al (2006). Surgical and pallia-tive management and outcome in 184 patients with hilar cholangiocarcinoma: palliative photodynamic therapy plus stenting is comparable to r1/r2 resection. Ann Surg, 244, 230-9.   DOI
18 Yeh TS, Tseng JH, Chen TC, et al (2005). Characterization of intrahepatic cholangiocarcinoma of the intraductal growthtype and its precursor lesions. Hepatology, 42, 657-64.   DOI
19 Zhou YM, Yang JM, et al (2008). Clinicopathologic characteristics of intrahepatic cholangiocarcinoma in patients with positive serum a-fetoprotein. World J Gastroenterol, 14, 2251-4.   DOI
20 Glockner JF (2007). Hepatobiliary MRI: current concepts and controversies. J Magn Reson Imaging, 25, 681-95.   DOI
21 Han SL, Zhou HZ, Cheng J, et al (2009). Diagnosis and surgical treatment of intrahepatic hepatolithiasis associated cholangiocarcinoma. Asian J Surg, 32, 4-5.
22 Jan YY, Yeh CN, Yeh TS, et al (2005). Prognostic analysis of surgical treatment of peripheral cholangiocarcinoma: two decades of experience at Chang Gung Memorial Hospital. World J Gastroenterol, 11, 1779-84.   DOI
23 Kinjo N, Shimada M, Maeda T, et al (2005). Preoperatively undiagnosable intrahepatic bile duct dilatation contains early-stage intrahepatic cholangiocarcinoma. Hepatogastroenterology, 52, 1368-71.
24 Kuroki T, Tajima Y, Kanematsu T (2005). Hepatolithiasis and intrahepatic cholangiocarcinoma: carcinogenesis based on molecular mechanisms. J Hepatobiliary Pancreat Surg, 12, 463-6.   DOI
25 Lang H, Sotiropoulos GC, Brokalaki E, et al (2006). Surgical therapy of intrahepatic cholangiocellular carcinoma. Chirurg, 77, 53-60.   DOI
26 Lazaridis KN, Gores GJ (2005). Cholangiocarcinoma. Gastroenterology, 128, 1655-67   DOI   ScienceOn
27 Li YG, Zhang N (2009). Clinical significance of serum tumour M2-pk and CA19-9 detection in the diagnosis of cholangiocarcinoma. Dig Livor Dis, 44, 605-8.
28 Morris-Stiff G, Bhati C, Olliff S, et al (2008). Cholangiocarcinoma complicating primary sclerosing cholangitis: a 24-year experience. Dig Surg, 25, 126-32.   DOI
29 Paik WH, Park YS, Hwang JH, et al (2009). Palliative treatment with self-expandable metallic stents in patients with advanced type III or IV hilar cholangiocarcinoma: a percutaneous versus endoscopic approach. Gastrointest Endosc, 69, 55-62.   DOI