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Classification of Intrahepatic Cholangiocarcinoma into Perihilar Versus Periphe...

Wei, T; Lu, J; Xiao, XL; Weiss, M; Popescu, I; Pinto Marques, H; Aldrighetti, L; Maithel, SK; Pulitano, C; Bauer, TW; Shen, F; Poultsides, GA

Background: Intrahepatic cholangiocarcinoma (ICC) constitutes a group of heterogeneous malignancies within the liver. We sought to subtype ICC based on anatomical origin of tumors, as well as propose modifications of the current classification system. Methods: Patients undergoing curative-intent resection for ICC, hilar cholangiocarcinoma (CCA), or hepatocellular carcinoma (HCC) were identified from three inter...


Tumor Necrosis Impacts Prognosis of Patients Undergoing Resection for T1 Intrah...

Tsilimigras, DI; Ejaz, A; Cloyd, J; Guglielmi, A; Aldrighetti, L; Weiss, M; Bauer, TW; Alexandrescu, S; Poultsides, GA; Maithel, SK; Pinto Marques, H

Background: The prognostic impact of tumor necrosis among patients undergoing resection for intrahepatic cholangiocarcinoma (ICC) remains ill-defined. Methods: Patients who underwent curative-intent resection for ICC between 2000 and 2017 were identified using a multi-institutional database. The association of pathologic tumor necrosis with overall survival (OS) and recurrence-free survival (RFS) was examined. ...


Non-transplantable Recurrence After Resection for Transplantable Hepatocellular...

Zhang, XF; Xue, F; Bagante, F; Ratti, F; Marques, HP; Silva, S; Soubrane, O; Lam, V; Poultsides, GA; Popescu, I; Grigorie, R; Alexandrescu, S; Martel, G

Objectives: To identify the preoperative risk factors for prediction of non-transplantable recurrence (NTR) after tumor resection for early-stage hepatocellular carcinoma (HCC) to assist in patient selection relative to upfront liver resection (LR) versus liver transplantation (LT). Methods: Patients who underwent curative resection for transplantable HCC and chronic liver disease were identified from an intern...


Impact of Time‐to‐Surgery on Outcomes of Patients Undergoing Curative‐Intent Li...

Tsilimigras, DI; Hyer, JM; Diaz, A; Moris, D; Bagante, F; Ratti, F; Pinto Marques, H; Soubrane, O; Lam, V; Poultsides, GA; Popescu, I; Alexandrescu, S

Background: The impact of a prolonged time-to-surgery (TTS) among patients with resectable hepatocellular carcinoma (HCC) is not well defined. Methods: Patients who underwent curative-intent hepatectomy for BCLC-0, A and B HCC between 2000 and 2017 were identified using a multi-institutional database. The impact of prolonged TTS on overall survival (OS) and disease-free survival (DFS) was examined. Results: Amo...


Proposed modification of the Eighth Edition of the AJCC Staging System for Intr...

Zhang, XF; Xue, F; He, J; Alexandrescu, S; Marques, HP; Aldrighetti, L; Maithel, SK; Pulitano, C; Bauer, TW; Shen, F; Poultsides, GA; Soubrane, O

Background: To improve the prognostic accuracy of the 8th edition of the American Joint Committee on Cancer (AJCC) staging system for intrahepatic cholangiocarcinoma (ICC) with establishment and validation of a modified TNM (mTNM) staging system. Methods: Data on patients who underwent curative-intent resection for ICC was collected from 15 high-volume centers worldwide (n = 643). An external validation dataset...


Impact of Tumor Burden Score on Conditional Survival after Curative-Intent Rese...

Elfadaly, AN; Tsilimigras, DI; Hyer, JM; Paro, A; Bagante, F; Ratti, F; Marques, HP; Soubrane, O; Lam, V; Poultsides, GA; Popescu, I; Alexandrescu, S

Background: The impact of tumor burden score (TBS) on conditional survival (CS) among patients undergoing curative-intent resection of hepatocellular carcinoma (HCC) has not been examined to date. Methods: Patients who underwent liver resection of HCC between 2000 and 2017 were identified from a multi-institutional database. The impact of TBS and other clinicopathologic factors on 3-year conditional survival (C...


Multi-Institutional Development and External Validation of a Nomogram for Predi...

Wei, T; Zhang, XF; Xue, F; Bagante, F; Ratti, F; Pinto Marques, H; Silva, S; Soubrane, O; Lam, V; Poultsides, GA; Popescu, I; Grigorie, R

Backgrounds: Extrahepatic recurrence of hepatocellular carcinoma (HCC) after surgical resection is associated with unfavorable prognosis. The objectives of the current study were to identify the risk factors and develop a nomogram for the prediction of extrahepatic recurrence after initial curative surgery. Methods: A total of 635 patients who underwent curative-intent resection for HCC between 2000 and 2017 we...


Tumor Burden Dictates Prognosis Among Patients Undergoing Resection of Intrahep...

Tsilimigras, DI; Hyer, JM; Paredes, AZ; Moris, D; Sahara, K; Guglielmi, A; Aldrighetti, L; Weiss, M; Bauer, TW; Alexandrescu, S; Poultsides, GA

Introduction: While tumor burden (TB) has been associated with outcomes among patients with hepatocellular carcinoma, the role of overall TB in intrahepatic cholangiocarcinoma (ICC) remains poorly defined. Methods: Patients undergoing curative-intent resection of ICC between 2000 and 2017 were identified from a multi-institutional database. The impact of TB on overall (OS) and disease-free survival (DFS) was ev...


Postoperative Infectious Complications Worsen Long-Term Survival After Curative...

Wei, T; Zhang, XF; Bagante, F; Ratti, F; Marques, HP; Silva, S; Soubrane, O; Lam, V; Poultsides, GA; Popescu, I; Grigorie, R; Alexandrescu, S; Martel, G

Background: Postoperative infectious complications may be associated with a worse long-term prognosis for patients undergoing surgery for a malignant indication. The current study aimed to characterize the impact of postoperative infectious complications on long-term oncologic outcomes among patients undergoing resection for hepatocellular carcinoma (HCC). Methods: Patients who underwent curative-intent resecti...


Serum α-Fetoprotein Levels at Time of Recurrence Predict Post-Recurrence Outcom...

Tsilimigras, DI; Moris, D; Hyer, JM; Bagante, F; Ratti, F; Marques, HP; Soubrane, O; Lam, V; Poultsides, GA; Popescu, I; Alexandrescu, S; Martel, G

Introduction: Although preoperative α-fetoprotein (AFP) has been recognized as an important tumor marker among patients with hepatocellular carcinoma (HCC), the predictive value of AFP levels at the time of recurrence (rAFP) on post-recurrence outcomes has not been well examined. Methods: Patients undergoing curative-intent resection of HCC between 2000 and 2017 were identified using a multi-institutional datab...


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