ArticleHepatology (Baltimore, Md.)2021
Liver Metastases of Intrahepatic Cholangiocarcinoma: Implications for an Updated Staging System.
Article in Hepatology (Baltimore, Md.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 1 of them a synthesis that pooled it.
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Who cites it
38 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Long-Term Survivor of Intrahepatic Cholangiocarcinoma for over 18 Years: Case Study with Longitudinal Histo-molecular and Tumor Immune Microenvironment Characterization and Systematic Review of the Literature.Journal of gastrointestinal cancer · 2024Pooled it
- Advanced extrahepatic cholangiocarcinoma and gallbladder cancer: Post-hoc analysis of the ABC-01, -02 and -03 clinical trials.JHEP reports : innovation in hepatology · 2026Trial
- Liver transplantation in unresectable intrahepatic cholangiocarcinoma following neoadjuvant chemotherapy and SIRT.JHEP reports : innovation in hepatology · 2026Article
- Prognostic implications of tumour number in intrahepatic cholangiocarcinoma.JHEP reports : innovation in hepatology · 2026Article
- Outcomes After Resection for Multiple Intrahepatic Cholangiocarcinoma-A National Population-Based Study.Annals of surgical oncology · 2026Article
- The construction and validation of a nomogram for lung metastasis of intrahepatic cholangiocarcinoma: a study based on the SEER database.Translational cancer research · 2026Article
- Prognostic Impact of Metastatic Sites in Patients with Biliary Tract Cancer Treated with Cisplatin, Gemcitabine, and Durvalumab.Targeted oncology · 2026Article
- Cholangiocarcinoma 2026: status quo, unmet needs and priorities.Nature reviews. Gastroenterology & hepatology · 2026Review
- Intrahepatic cholangiocarcinoma as a unique subtype: key updates from current guidelines.Journal of cancer research and clinical oncology · 2025Article
- Oncological Resectability Criteria for Intrahepatic Cholangiocarcinoma: A Preoperative Framework for Multidisciplinary Management.Annals of surgical oncology · 2025Article
- Ivosidenib for IDH1-Mutant Intrahepatic Cholangiocarcinoma: Insights From a Multicenter Real-World Study.Liver international : official journal of the International Association for the Study of the Liver · 2025Observational
- Standardizing the reporting of cholangiocarcinoma: the society of abdominal radiology disease focused panel on cholangiocarinoma lexicon.Abdominal radiology (New York) · 2025Review
- Article
- Resection of multifocal intrahepatic cholangiocarcinoma.The British journal of surgery · 2025Article
- Mapping the landscape of biliary tract cancer in Europe: challenges and controversies.The Lancet regional health. Europe · 2025Review
- The comprehensive potential of AQP1 as a tumor biomarker: evidence from kidney neoplasm cohorts, cell experiments and pan-cancer analysis.Human genomics · 2025Article
- Epigenetic silencing of miR-125a-3p promotes the progress of human cholangiocarcinoma via increasing CAC1 expression.Heliyon · 2024Article
- Recommendations on maximising the clinical value of tissue in the management of patients with intrahepatic cholangiocarcinoma.JHEP reports : innovation in hepatology · 2024Article
- Complete regression of intrahepatic cholangiocarcinoma after right portal vein ligation. Case report.International journal of surgery case reports · 2024Article
- Clinical management of intrahepatic cholangiocarcinoma: surgical approaches and systemic therapies.Frontiers in oncology · 2024Review
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19 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimsIntrahepatic cholangiocarcinoma (iCCA) with liver metastases is perceived to have a poor prognosis, but the American Joint Committee on Cancer (AJCC) classifies them as early stage in the absence of lymph nodes or extrahepatic spread. APPROACH AND
resultsPatients with iCCA from the European Network for the Study of Cholangiocarcinoma (ENS-CCA) and Surveillance, Epidemiology, and End Results (SEER) registries with survival/staging (AJCC v.7) data were eligible. Modified staging was used (mAJCC v.7): group A: stages I-III (excluding T2bN0); group B: stage IVa (excluding T2bN1M0); group C: liver metastases (T2bN0/1); and group D: stage IVb (extrahepatic metastases). Survival analysis (Kaplan-Meier and Cox regression) was performed in an ENS-CCA training cohort (TC) and findings internally (ENS-CCA iVC) and externally (SEER) validated. The aim was to assess whether liver metastases (group C) had a shorter survival compared to other early stages (group A) to propose a modified version of AJCC v.8 (mAJCC v.8). A total of 574 and 4,171 patients from the ENS-CCA and SEER registries were included. Following the new classification, 19.86% and 17.31% of patients from the ENS-CCA and SEER registries were reclassified into group C, respectively. In the ENS-CCA TC, multivariable Cox regression was adjusted for obesity (p = 0.026) and performance status (P < 0.001); patients in group C (HR, 2.53; 95% CI, 1.18-5.42; P = 0.017) had a higher risk of death (vs. group A). Findings were validated in the ENS-CCA iVC (HR, 2.93; 95% CI, 2.04-4.19; P < 0.001) and in the SEER registry (HR, 1.88; 95% CI, 1.68-2.09; P < 0.001).
conclusionsiCCA with liver metastases has a worse outcome than other early stages of iCCA. Given that AJCC v.8 does not take this into consideration, a modification of AJCC v.8 (mAJCC v.8), including "liver metastases: multiple liver lesions, with or without vascular invasion" as an "M1a stage," is suggested.
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