Liu Pei, Song Yinghui, Shakoor Kashif, Peng Chuang, Liu Sulai
Department of Hepatobiliary Surgery, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University; Changsha 410005, China.
Central Laboratory of Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan 410005, P.R. China.
J Cancer. 2022 Oct 9;13(13):3444-3451. doi: 10.7150/jca.76696. eCollection 2022.
Perihilar cholangiocarcinoma (PCC) is a malignant mass originating from the bile ducts. There is currently no unified treatment plan, and there are various treatment methods applied in clinical practice, as well as several different staging and typing systems to guide resectability, prognosis and survival prediction. The choice of treatment for PCC is closely related to the stage of the tumor. Accurate preoperative staging is necessary for correct resectability assessment and the selection of a reasonable treatment plan and surgical method; similarly, accurate postoperative pathological staging is necessary to guide further treatment and judgment of the patient's prognosis. A universally accepted staging system facilitates the comparison of cases between different centers, but there is much debate about the classification and staging of PCC. At present, the existing staging systems include the Bismuth-Corlette classification, AJCC/UICC TNM staging, modified T staging, Gazzaniga staging, JSBS staging, and Mayo staging. Each system has advantages, but there is no comprehensive guide for tumor resectability, prognosis, and survival. In this paper, the pros and cons of the different systems for staging PCC in terms of resectability, prognosis and survival prediction are discussed.
肝门部胆管癌（PCC）是一种起源于胆管的恶性肿瘤。目前尚无统一的治疗方案，临床实践中应用的治疗方法多种多样，还有几种不同的分期和分型系统用于指导可切除性、预后及生存预测。PCC的治疗选择与肿瘤分期密切相关。准确的术前分期对于正确评估可切除性、选择合理的治疗方案和手术方法至关重要；同样，准确的术后病理分期对于指导进一步治疗和判断患者预后也很有必要。一个被普遍接受的分期系统有助于不同中心之间病例的比较，但关于PCC的分类和分期存在很多争议。目前，现有的分期系统包括Bismuth-Corlette分类、AJCC/UICC TNM分期、改良T分期、Gazzaniga分期、JSBS分期和Mayo分期。每个系统都有优点，但对于肿瘤的可切除性、预后及生存情况均缺乏全面的指导。本文讨论了不同PCC分期系统在可切除性、预后及生存预测方面的优缺点。
