Histological evaluation of tumor differentiation score and prognosis of extrahepatic bile duct cancer: A proposal for a new histological grading system.
classification
extrahepatic bile duct cancer
histological differentiation
survival
Journal
Pathology international
ISSN: 1440-1827
Titre abrégé: Pathol Int
Pays: Australia
ID NLM: 9431380
Informations de publication
Date de publication:
Nov 2020
Nov 2020
Historique:
received:
09
07
2020
accepted:
18
08
2020
pubmed:
11
9
2020
medline:
8
10
2021
entrez:
10
9
2020
Statut:
ppublish
Résumé
Extrahepatic bile duct (EHBD) cancer is a devastating cancer, and more common in Asian countries than in Western countries. Histological grading continues to be a highly relevant factor in prognosis and management of many kinds of cancer, however no uniform histological grading system exists for EHBD cancer. Histological heterogeneity within tumors is a problem in the evaluation of EHBD cancer. We developed an EHBD histological grading scheme to evaluate tumor differentiation pattern, and statistically analyzed its relationship with prognosis. In the present study, 257 surgically resected EHBD cancers were reviewed and their histological glandular differentiation (HGD) pattern was scored, and then we summed up the most and second most predominant scores. These scores were statistically analyzed for their relationship with patient prognosis. Patients showed a trend of shortening recurrence-free survival (RFS) and overall survival (OS) in association with higher HGD scores. In multivariate analyses, HGD score was determined to be an influential factor in RFS (P = 0.00041) and OS (P < 0.0001). In addition, combining HGD score and lymph node status correctly stratified patient prognosis in RFS. In conclusion, this new HGD scoring system is highly practical and has powerful prognostic value for EHBD cancer.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
857-864Subventions
Organisme : Grans-in-Aid for Scientific Research, JSPS KAKENHI
ID : 18K07024
Informations de copyright
© 2020 Japanese Society of Pathology and John Wiley & Sons Australia, Ltd.
Références
de Groen PC, Gores GJ, LaRusso NF, Gunderson LL, Nagorney DM. Biliary tract cancers. N Engl J Med 1999; 341: 1368-78.
Khan SA, Thomas HC, Davidson BR, Taylor-Robinson SD. Cholangiocarcinoma. Lancet 2005; 366: 1303-14.
DeOliveira ML, Cunningham SC, Cameron JL et al. Cholangiocarcinoma: Thirty-one-year experience with 564 patients at a single institution. Ann Surg 2007; 245: 755-62.
Brierley J, Gospodarowicz MK, Wittekind C. Digestive System Tumours. TNM Classification of Malignant Tumours, 8th edn. Hoboken: Wiley-Blackwell, 2017: 87-90.
Weinbren K, Mutum SS. Pathological aspects of cholangiocarcinoma. J Pathol 1983; 139: 217-38.
Hruban RH, Adsay NV, Esposito I et al. Pancreatic ductal adenocarcinoma. In: The WHO Classification of Tumours Editorial Board, eds. WHO Classification of Tumours: Digestive System Tumours, 5th edn. Lyon: International Agency for Research on Cancer; 2019. ISBN : 978-92-832-4499-8.
Adsay NV, Basturk O, Bonnett M et al. A proposal for a new and more practical grading scheme for pancreatic ductal adenocarcinoma. Am J Surg Pathol 2005; 29: 724-33.
Nakanuma Y, Kakuda Y. Pathologic classification of cholangiocarcinoma: New concepts. Best Pract Res Clin Gastroenterol 2015; 29: 277-93.
Kanda Y. Investigation of the freely available easy-to-use software ‘EZR’ for medical statistics. Bone Marrow Transplant 2013; 48: 452-8.
Versteijne E, Vogel JA, Besselink MG et al. Meta-analysis comparing upfront surgery with neoadjuvant treatment in patients with resectable or borderline resectable pancreatic cancer. Br J Surg 2018; 105: 946-58.
Kayahara M, Nagakawa T, Ohta T, Kitagawa H, Tajima H, Miwa K. Role of nodal involvement and the periductal soft-tissue margin in middle and distal bile duct cancer. Ann Surg 1999; 229: 76-83.
Kosuge T, Yamamoto J, Shimada K, Yamasaki S, Makuuchi M. Improved surgical results for hilar cholangiocarcinoma with procedures including major hepatic resection. Ann Surg 1999; 230: 663-71.
Alexander F, Rossi RL, O'Bryan M, Khettry U, Braasch JW, Watkins E Jr. Biliary carcinoma: A review of 109 cases. Am J Surg 1984; 147: 503-509.
Okuda K, Kubo Y, Okazaki N, Arishima T, Hashimoto M. Clinical aspects of intrahepatic bile duct carcinoma including hilar carcinoma: A study of 57 autopsy-proven cases. Cancer 1977; 39: 232-46.
Tompkins RK, Saunders K, Roslyn JJ, Longmire WP Jr. Changing patterns in diagnosis and management of bile duct cancer. Ann Surg 1990; 211: 614-20.
Whelton MJ, Petrelli M, George P, Young WB, Sherlock S. Carcinoma at the junction of the main hepatic ducts. Q J Med 1969; 38: 211-30.
Tompkins RK, Johnson J, Storm FK, Longmire WP Jr. Operative endoscopy in the management of biliary tract neoplasms. Am J Surg 1976; 132: 174-82.