Evidence map›Paper›PMID 33565011›Full record

ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2021

Detection of Tumor Multifocality in Resectable Intrahepatic Cholangiocarcinoma: Defining the Optimal Pre-operative Imaging Modality.

Thomas L Sutton, Kevin G Billingsley, Brett S Walker, Alice W Fung, Erin Maynard, C Kristian Enestvedt, Elizabeth N Dewey, Brian T Brinkerhoff, Charles D Lopez, Susan L Orloff and 1 more

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Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.0field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 9 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 3 institutions in 1 country.

Thomas L SuttonDepartment of Surgery, Division of Surgical Oncology, Oregon Heath & Science University (OHSU), 3181 SW Sam Jackson Park Rd, Mail Code: L-619, Portland, OR, 97239, USA.
Kevin G BillingsleyDepartment of Surgery, Division of Surgical Oncology, Oregon Heath & Science University (OHSU), 3181 SW Sam Jackson Park Rd, Mail Code: L-619, Portland, OR, 97239, USA.
Brett S WalkerDepartment of Surgery, Division of Surgical Oncology, Oregon Heath & Science University (OHSU), 3181 SW Sam Jackson Park Rd, Mail Code: L-619, Portland, OR, 97239, USA.
Alice W FungThe Knight Cancer Institute at OHSU, Portland, OR, 97239, USA.
Erin MaynardDepartment of Surgery, Division of Abdominal Organ Transplantation/Hepatobiliary Surgery, OHSU, Portland, OR, 97239, USA.
C Kristian EnestvedtDepartment of Surgery, Division of Abdominal Organ Transplantation/Hepatobiliary Surgery, OHSU, Portland, OR, 97239, USA.
Elizabeth N DeweyDepartment of Surgery, OHSU, Portland, OR, 97239, USA.
Brian T BrinkerhoffDepartment of Pathology, OHSU, Portland, OR, 97239, USA.
Charles D LopezThe Knight Cancer Institute at OHSU, Portland, OR, 97239, USA.
Susan L OrloffDepartment of Surgery, Division of Abdominal Organ Transplantation/Hepatobiliary Surgery, OHSU, Portland, OR, 97239, USA.
Skye C MayoDepartment of Surgery, Division of Surgical Oncology, Oregon Heath & Science University (OHSU), 3181 SW Sam Jackson Park Rd, Mail Code: L-619, Portland, OR, 97239, USA. mayos@ohsu.edu.ORCID http://orcid.org/0000-0002-1631-9855
Oregon Health & Science University · USUniversity of Portland · USOregon Health and Science University Hospital · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMultiple tumor foci (MTF) in intrahepatic cholangiocarcinoma (ICC), including satellitosis and true multifocality, is a known negative prognostic factor and can inform pre-operative decision-making. Lack of standardized pre-operative liver staging practices may contribute to undiagnosed MTF and poor outcomes. We sought to investigate the sensitivity of different cross-sectional imaging modalities for MTF at our institution.

methodsWe identified n = 52 patients with ICC who underwent curative-intent resection from 2004 to 2017 in a multidisciplinary hepato-pancreato-biliary cancer program. Timing and modality of pre-operative imaging were recorded. Blinded review of imaging was performed and modalities were evaluated for false-negative rate (FNR) in detecting MTF, satellitosis, and true multifocality.

resultsForty-one (79%) patients underwent CT and 20 (38%) underwent MRI prior to hepatectomy. MTF was pre-operatively identified in six (12%) patients. An additional seven patients had MTF discovered on final surgical pathology, despite a median interval from CT/MRI to surgery of 20 days. On blinded review the FNR of MRI compared to CT for multifocality was 0% vs. 38%, 50% vs 80% for satellitosis, and 22% vs 46% for MTF as a whole.

conclusionCT is inadequate for pre-operative diagnosis of MTF in resectable ICC, even when performed within 30 days of hepatectomy. We recommend liver-protocol MRI as the standard pre-operative imaging modality in non-metastatic ICC.

Indexed as

Bile Duct NeoplasmsCholangiocarcinomaLiver NeoplasmsBile Ducts, IntrahepaticHepatectomyHumansPrognosisDetectionIntrahepatic cholangiocarcinomaPre-operative imagingTumor multifocality

Identifiers

PMID33565011
OpenAlexW3129048985

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.