A Proposed Staging System for Intrahepatic Cholangiocarcinoma

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 t...

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محفوظ في:
التفاصيل البيبلوغرافية
المؤلف الرئيسي: Nathan, Hari (author)
مؤلفون آخرون: Aloia, Thomas (author), Vauthey, Jean-Nicolas (author), Abdalla, Eddie (author), Zhu, Andrew (author), Schulick, Richard (author), Choti, Micheal (author), Pawlik, Timothy (author)
التنسيق: article
منشور في: 2009
الوصول للمادة أونلاين:http://hdl.handle.net/10725/2603
http://dx.doi.org/10.1245/s10434-008-0180-z
http://link.springer.com/article/10.1245/s10434-008-0180-z
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author Nathan, Hari
author2 Aloia, Thomas
Vauthey, Jean-Nicolas
Abdalla, Eddie
Zhu, Andrew
Schulick, Richard
Choti, Micheal
Pawlik, Timothy
author2_role author
author
author
author
author
author
author
author_facet Nathan, Hari
Aloia, Thomas
Vauthey, Jean-Nicolas
Abdalla, Eddie
Zhu, Andrew
Schulick, Richard
Choti, Micheal
Pawlik, Timothy
author_role author
dc.creator.none.fl_str_mv Nathan, Hari
Aloia, Thomas
Vauthey, Jean-Nicolas
Abdalla, Eddie
Zhu, Andrew
Schulick, Richard
Choti, Micheal
Pawlik, Timothy
dc.date.none.fl_str_mv 2009
2015-11-18T06:44:53Z
2015-11-18T06:44:53Z
2015-11-18
dc.identifier.none.fl_str_mv 1068-9265
http://hdl.handle.net/10725/2603
http://dx.doi.org/10.1245/s10434-008-0180-z
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.
http://link.springer.com/article/10.1245/s10434-008-0180-z
dc.language.none.fl_str_mv en
dc.relation.none.fl_str_mv Annals of Surgical Oncology
dc.rights.*.fl_str_mv info:eu-repo/semantics/openAccess
dc.title.none.fl_str_mv A Proposed Staging System for Intrahepatic Cholangiocarcinoma
dc.type.none.fl_str_mv Article
info:eu-repo/semantics/publishedVersion
info:eu-repo/semantics/article
description 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.
eu_rights_str_mv openAccess
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id LAURepo_86748c75300aa34f2a355d97f33fc5ef
identifier_str_mv 1068-9265
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.
language_invalid_str_mv en
network_acronym_str LAURepo
network_name_str Lebanese American University repository
oai_identifier_str oai:laur.lau.edu.lb:10725/2603
publishDate 2009
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spelling A Proposed Staging System for Intrahepatic CholangiocarcinomaNathan, HariAloia, ThomasVauthey, Jean-NicolasAbdalla, EddieZhu, AndrewSchulick, RichardChoti, MichealPawlik, TimothyThe 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.PublishedN/A2015-11-18T06:44:53Z2015-11-18T06:44:53Z20092015-11-18Articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article1068-9265http://hdl.handle.net/10725/2603http://dx.doi.org/10.1245/s10434-008-0180-zNathan, 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.http://link.springer.com/article/10.1245/s10434-008-0180-zenAnnals of Surgical Oncologyinfo:eu-repo/semantics/openAccessoai:laur.lau.edu.lb:10725/26032019-02-26T10:48:53Z
spellingShingle A Proposed Staging System for Intrahepatic Cholangiocarcinoma
Nathan, Hari
status_str publishedVersion
title A Proposed Staging System for Intrahepatic Cholangiocarcinoma
title_full A Proposed Staging System for Intrahepatic Cholangiocarcinoma
title_fullStr A Proposed Staging System for Intrahepatic Cholangiocarcinoma
title_full_unstemmed A Proposed Staging System for Intrahepatic Cholangiocarcinoma
title_short A Proposed Staging System for Intrahepatic Cholangiocarcinoma
title_sort A Proposed Staging System for Intrahepatic Cholangiocarcinoma
url http://hdl.handle.net/10725/2603
http://dx.doi.org/10.1245/s10434-008-0180-z
http://link.springer.com/article/10.1245/s10434-008-0180-z