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Predicting Lymph Node Metastasis in Intrahepatic Cholangiocarcinoma

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

Background: The objective of the current study was to develop a model to predict the likelihood of occult lymph node metastasis (LNM) prior to resection of intrahepatic cholangiocarcinoma (ICC). Methods: Patients who underwent hepatectomy for ICC between 2000 and 2017 were identified using a multi-institutional database. A novel model incorporating clinical and preoperative imaging data was developed to predict...


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...


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...


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...


A Machine-Based Approach to Preoperatively Identify Patients with the Most and ...

Tsilimigras, D; Mehta, R; Moris, D; Sahara, K; Bagante, F; Paredes, A; Moro, A; Guglielmi, A; Aldrighetti, L; Weiss, M; Bauer, T; Alexandrescu, S

Background: Accurate risk stratification and patient selection is necessary to identify patients who will benefit the most from surgery or be better treated with other non-surgical treatment strategies. We sought to identify which patients in the preoperative setting would likely derive the most or least benefit from resection of intrahepatic cholangiocarcinoma (ICC). Methods: Patients who underwent curative-in...


Very Early Recurrence After Liver Resection for Intrahepatic Cholangiocarcinoma...

Tsilimigras, D; Sahara, K; Wu, L; Moris, D; Bagante, F; Guglielmi, A; Aldrighetti, L; Weiss, M; Bauer, T; Alexandrescu, S; Poultsides, G; Maithel, S

Importance: Although surgery offers the best chance of a potential cure for patients with localized, resectable intrahepatic cholangiocarcinoma (ICC), prognosis of patients remains dismal largely because of a high incidence of recurrence. Objective: To predict very early recurrence (VER) (ie, recurrence within 6 months after surgery) following resection for ICC in the pre- and postoperative setting. Design, set...


Effect of Surgical Margin Width on Patterns of Recurrence among Patients Underg...

Tsilimigras, D; Sahara, K; Moris, D; Hyer, J; Paredes, A; Bagante, F; Merath, K; Farooq, A; Ratti, F; Pinto Marques, H; Soubrane, O; Azoulay, D; Lam, V

Introduction: Although a positive surgical margin is a known prognostic factor for recurrence, the optimal surgical margin width in the context of an R0 resection for early-stage hepatocellular carcinoma (HCC) is still debated. The aim of the current study was to examine the impact of wide (> 1 cm) versus narrow (< 1 cm) surgical margin status on the incidence and recurrence patterns among patients with T1 HCC ...


Hepatocellular Carcinoma Tumour Burden Score to Stratify Prognosis After Resection

Tsilimigras, D; Moris, D; Hyer, J; Bagante, F; Sahara, K; Moro, A; Paredes, A; Mehta, R; Ratti, F; Pinto Marques, H; Silva, S; Soubrane, O; Lam, V

Background: Although the Barcelona Clinic Liver Cancer (BCLC) staging system has been largely adopted in clinical practice, recent studies have emphasized the need for further refinement and subclassification of this system. Methods: Patients who underwent hepatectomy with curative intent for BCLC-0, -A or -B hepatocellular carcinoma (HCC) between 2000 and 2017 were identified using a multi-institutional databa...


Utilizing Machine Learning for Pre- and Postoperative Assessment of Patients Un...

Tsilimigras, D; Mehta, R; Moris, D; Sahara, K; Bagante, F; Paredes, A; Farooq, A; Ratti, F; Pinto Marques, H; Silva, S; Soubrane, O; Lam, V

Background: There is an ongoing debate about expanding the resection criteria for hepatocellular carcinoma (HCC) beyond the Barcelona Clinic Liver Cancer (BCLC) guidelines. We sought to determine the factors that held the most prognostic weight in the pre- and postoperative setting for each BCLC stage by applying a machine learning method. Methods: Patients who underwent resection for BCLC-0, A and B HCC betwee...


Prognostic Utility of Albumin-Bilirubin Grade for Short- and Long-Term Outcomes...

Tsilimigras, D; Hyer, J; Moris, D; Sahara, K; Bagante, F; Guglielmi, A; Aldrighetti, L; Alexandrescu, S; Pinto Marques, H; Shen, F; Koerkamp, B; Endo, I

Background: The objective of the current study was to define the impact of albumin-bilirubin (ALBI) grade on short- as well as long-term outcomes among patients with intrahepatic cholangiocarcinoma (ICC). Methods: Patients who underwent hepatectomy for ICC between 1990 and 2016 were identified using an international multi-institutional database. Clinicopathologic factors including ALBI score were assessed using...


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