Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan.
J Surg Oncol. 2011 Aug 1;104(2):130-9. doi: 10.1002/jso.21917. Epub 2011 Mar 29.
Outcomes after hepatectomy in patients with mass-forming (MF) type intrahepatic cholangiocarcinoma (ICC) with marked enhancement within the tumor on arterial-phase computed tomography (CT) scans have not been clarified in detail.
We retrospectively studied 140 patients with MF type ICC who underwent hepatectomy from 1989 through 2008. Surgical outcomes were compared between 25 patients with MF type ICC with marked enhancement within the tumor (hypervascular ICC) and 109 patients without enhancement within the tumor (hypovascular ICC) on arterial-phase CT scans.
Portal invasion and intrahepatic metastasis were significantly lower in patients with hypervascular ICC than in those with hypovascular ICC. The 5-year survival rate was significantly higher in patients with hypervascular ICC (86%) than in patients with hypovascular ICC (27%, P < 0.0001). Multivariate analysis showed hypervascular ICC on arterial-phase CT scans, normal level of cancer-associated carbohydrate antigen 19-9, absence of portal invasion, and absence of intrahepatic metastasis of ICC to be significant independent prognostic factors for overall survival in patients with MF type ICC.
MF type ICC with marked enhancement within the tumor on arterial CT scans showed a favorable surgical outcome due to its less invasive histopathologic characteristics in patients with MF type ICC.
在动脉期 CT 扫描中肿瘤内明显增强的肿块型（MF）肝内胆管细胞癌（ICC）患者的肝切除术后结果尚未详细阐明。
我们回顾性研究了 1989 年至 2008 年间接受肝切除术的 140 例 MF 型 ICC 患者。在动脉期 CT 扫描中，将 25 例肿瘤内明显增强（富血管 ICC）的 MF 型 ICC 患者与 109 例肿瘤内无增强（少血管 ICC）的患者进行比较，评估手术结果。
与少血管 ICC 患者相比，富血管 ICC 患者的门静脉侵犯和肝内转移明显较低。富血管 ICC 患者的 5 年生存率明显高于少血管 ICC 患者（86% vs. 27%，P<0.0001）。多因素分析显示，动脉期 CT 扫描显示富血管 ICC、正常的癌相关碳水化合物抗原 19-9 水平、无门静脉侵犯和无 ICC 肝内转移是 MF 型 ICC 患者总生存的独立预后因素。
动脉 CT 扫描中肿瘤内明显增强的 MF 型 ICC 具有较好的手术结果，这与其在 MF 型 ICC 患者中具有侵袭性较低的组织病理学特征有关。
