Cholangiocarcinoma: classification and staging
https://doi.org/10.24835/1607-0763-2018-5-55-64
Abstract
The main classifications of cholangiocarcinoma (CC) are currently the TNM classification, as well as the Bismuth–Corlette and MSKCC classifications. The criteria of T, N and M categories and characteristics of the stages of cholangiocarcinoma of the proximal and distal bile ducts, which are specified in the modern 8th edition of the international TNM classification, are presented. TNM classification is the most common for the development of treatment methods and the determination of disease prognosis. The Bismuth–Corlette classification, which characterizes the CC of the bile ducts in the region of the gate of the liver, is used to determine the type and volume of surgery. MSKCC classification of the CC of proximal bile ducts is designed to assess the prognosis of resectability, the risk of metastases and long-term survival of patients.
About the Authors
A. I. Shchegolev
Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology
N.I. Pirogov Russian National Research Medical University
Russian Federation
Russian Federation
doct. of med. sci., Professor, Head of Morbid Anatomy
professor of the Department of pathological anatomy and clinical pathological anatomy of the medical faculty
117997 Moscow, Russia, Acedemika Oparina str., 4
+7-495-531-44-44
U. N. Tumanova
Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology
Russian Federation
cand. of med. sci., senior researcher, Department of Morbid Anatomy
Russian Federation
cand. of med. sci., senior researcher, Department of Morbid Anatomy
G. G. Karmazanovsky
A.V.Vishnevsky National Medical Research Center for Surgery
Russian Federation
Russian Federation
сorresponding member of the Russian Academy of Sciences, doct. of med. sci., Professor, Head of Radiology Department
O. D. Mishnev
N.I. Pirogov Russian National Research Medical University
Russian Federation
Russian Federation
doct. of med. sci., Professor, Head of the Department of pathological anatomy and clinical pathological anatomy of the medical faculty
References
1. Khan S.A., Taylor-Robinson S.D., Toledano M.B., Beck A., Elliott P., Thomas H.C. Changing international trends in mortality rates for liver, biliary and pancreatic tumours. J. Hepatol. 2002; 37: 806–813.
2. Saha S.K., Zhu A.X., Fuchs C.S., Brooks G.A. Forty-year trends in cholangiocarcinoma incidence in the US: intrahepatic disease on the rise. Oncologist. 2016; 21: 594–599. DOI: 10.1634/theoncologist.2015-0446.
3. Sripa B., Pairojkul C. Cholangiocarcinoma: lessons from Thailand. Curr. Opin. Gastroenterol. 2008; 24: 349–356. DOI: 10.1097/MOG.0b013e3282fbf9b3.
4. Shaib Y., El-Serag H.B. The epidemiology of cholangiocarcinoma. Semin. Liver Dis. 2004; 24: 115–125. DOI: 10.1055/s-2004-828889.
5. West J., Wood H., Logan R.F., Quinn M., Aithal G.P. Trends in the incidence of primary liver and biliary tract cancers in England and Wales 1971–2001. Br. J. Cancer. 2006; 94: 1751–1758. DOI: 10.1038/sj.bjc.6603127.
6. Bergquist A., von Seth E. Epidemiology of cholangiocarcinoma. Best. Pract. Res. Clin. Gastroenterol. 2015; 29: 221–232. DOI: 10.1016/j.bpg.2015.02.003.
7. Bertuccio P., Bosetti C., Levi F., Decarli A., Negri E., La Vecchia C. A comparison of trends in mortality from primary liver cancer and intrahepatic cholangiocarcinoma in Europe. Ann Oncol. 2013; 24: 1667–1674. DOI: 10.1093/annonc/mds652.
8. Jarnagin W.R., Fong Y., DeMatteo R.P., Gonen M., Burke E.C., Bodniewicz B.S.J., Youssef B.A.M, Klimstra D., Blumgart L.H. Staging, resectability, and outcome in 225 patients with hilar cholangiocarcinoma. Ann. Surg. 2001; 234: 507–517.
9. Shchegolev A. I., Mishnev O. D. Oncomorphology liver. M.: Publishing RSSU, 2006; 252 p. (In Russian)
10. Chung Y.E., Kim M.J., Park Y.N., Choi J.Y., Pyo J.Y., Kim Y.C., Cho H.J., Kim K.A., Choi S.Y. Varying appearances of cholangiocarcinoma: radiologic-pathologic correlation. Radiographics. 2009; 3: 683–700. DOI: 10.1148/rg.293085729.
11. Akinfiev D.M., Bahmutova E.E., Beliakov G.A. Radiation diagnosis and minimally invasive treatment of mechanical jaundice. M.: Radiologia-press, 2010. 288 p. (In Russian)
12. Международная статистическая классификация болезней и проблем, связанных со здоровьем; 10-й пе
13. ресмотр. Женева: ВОЗ, 2003. Т.1. (In Russian)
14. TNM classification of malignant tumours. Ed. J.D. Brierley, M.K. Gospodarowicz., Ch. Wittekind – 8th ed. NY: Wiley-Blackwell, 2017. 272 p.
15. AJCC cancer staging manual, eighth ed. Ed. chief M.B. Amin. Springer, 2017. 1024 p.
16. Rizvi S., Khan S.A., Hallemeier C.L., Kelley R.K., Gores G.J. Cholangiocarcinoma – evolving concepts and therapeutic strategies. Nat. Rev. Clin. Oncol. 2018; 15: 95–111. DOI: 10.1038/nrclinonc.2017.157.
17. Shchegolev A.I., Tumanova U.N., Karmazanovsky G.G. Eighth edition of the International TNM classification of malignant tumors of the liver. Medical Visualization. 2017; 6: 41–48. DOI: 10.24835/1607-0763-2017-6-41-48. (In Russian)
18. American College of Radiology. Quality and safety resources: Liver Imaging–Reporting and Data System. Available at: http://www.acr.org/Quality-Safety/Resources/LIRADS. Accessed April 22, 2012.
19. Tumanova U.N., Karmazanovsky G.G., Shchegolev A.I. LIRADS system for computer-tomographic diagnosis of hepatocellular carcinoma. Medical Visualization. 2014; 6: 44–50. (In Russian)
20. Joo I., Lee J.M. Recent advances in the imaging diagnosis of hepatocellular carcinoma: value of gadoxetic acid-enhanced MRI. Liver Cancer. 2016; 5: 67–87. DOI: 10.1159/000367750.
21. Kajiyama K., Maeda T., Takenaka K., Sugimachi K., Tsuneyoshi M. The significance of stromal desmoplasia in intrahepatic cholangiocarcinoma: a special reference of “scirrhous-type” and “nonscirrhous-type” growth. Am. J. Surg. Pathol. 1999; 23: 892–902.
22. Razumilava N., Gores G.J. Classification, diagnosis, and management of cholangiocarcinoma. Clin. Gastroenterol. Hepatol. 2013; 11: 13–21. DOI: 10.1016/j.cgh.2012.09.009.
23. Joo I., Lee J.M., Yoon J.H. Imaging diagnosis of intrahepatic and perihilar cholangiocarcinoma: Recent advances and challenges. Radiology. 2018; 288: 7–13. DOI: 10.1148/radiol.2018171187.
24. Park H.J., Kim Y.K., Park M.J., Lee W.J. Small intrahepatic mass-forming cholangiocarcinoma: target sign on diffusion-weighted imaging for differentiation from hepatocellular carcinoma. Abdom. Imaging. 2013; 38: 793–801. DOI: 10.1007/s00261-012-9943-x.
25. Tumanova U.N., Karmazanovsky G.G., Dubova E.A., Shchegolev A.I. Comparative analysis of vascularization degree of hepatocellular carcinoma and focal nodular hyperplasia of the liver according to computed tomography and morphological studies. Vestnik Rossijskoj akademii medicinskix nauk. 2013; 12: 9–15. (In Russian)
26. Tumanova U.N., Karmazanovsky G.G., Shchegolev A.I. Characterize the degree of vascularization of hepatocellular carcinoma at spiral computed tomography. Medical Visualization. 2013; 1: 52–58. (In Russian)
27. Guglielmi A., Ruzzenente A., Campagnaro T., Pachera S., Conci S., Valdegamberi A., Sandri M., Iacono C. Prognostic significance of lymph node ratio after resection of perihilar cholangiocarcinoma. HPB (Oxford). 2011; 13: 240–245. DOI: 10.1111/j.1477-2574.2010.00277.x.
28. Guglielmi A., Ruzzenente A., Bertuzzo F., Iacono C. Assessment of nodal status for perihilar cholangiocarcinoma location, number, or ratio of involved nodes. Hepatobiliary Surg. Nutr. 2013; 2: 281–283. DOI: 10.1001/jamasurg.2016.1769.
29. Ruzzenente A., Bagante F., Ardito F., Campagnaro T., Scoleri I., Conci S., Iaconoa C., Giuliante F., Guglielmi A. Comparison of the 7th and 8th editions of the American Joint Committee on Cancer Staging Systems for perihilar cholangiocarcinoma. Surgery. 2018; 164: 244–250. DOI: 10.1016/j.surg.2018.03.012.
30. Jun S.-Y., Sung Y.-N., Lee J.H., Park K.-M., Lee Y.-J., Hong S.-M. Validation of the Eighth American Joint Committee on Cancer Staging System for distal bile duct carcinoma. Cancer Res. Treat. 2018; mar 2. DOI: 10.4143/crt.2017.595.
31. Moon A., Choi D.W., Choi S.H., Heo J.S., Jang K.T. Validation of T stage according to depth of invasion and N stage subclassification based on number of metastatic lymph nodes for distal extrahepatic bile duct (EBD) carcinoma. Medicine (Baltimore). 2015; 94: e2064. DOI: 10.1097/MD.0000000000002064.
32. Kiriyama M., Ebata T., Aoba T., Kaneoka Y., Arai T., Shimizu Y., Nagino M., Nagoya Surgical Oncology Group. Prognostic impact of lymph node metastasis in distal cholangiocarcinoma. Br. J. Surg. 2015; 102: 399–406. DOI: 10.1002/bjs.9752.
33. Kang J.S., Lee S., Son D., Han Y., Lee K.B., Kim J.R., Kwon W., Kim S.W., Jang J.Y. Prognostic predictability of the new American Joint Committee on Cancer 8th staging system for distal bile duct cancer: limited usefulness compared with the 7th staging system. J. Hepatobiliary Pancreat. Sci. 2018; 25: 124–130. DOI: 10.1002/jhbp.520.
34. Klatskin G. Adenocarcinoma of the hepatic duct at its bifurcation within the porta hepatis. An unusual tumor with distinctive clinical and pathological features. Am. J. Med. 1965; 38: 241–256.
35. Bismuth H., Corlette M.B. Intrahepatic cholangioenteric anastomosis in carcinoma of the hilus of the liver. Surg. Gynecol. Obstet. 1975; 140: 170–178.
36. Tsao J.I., Nimura Y., Kamiya J., Hayakawa N., Kondo S., Nagino M., Miyachi M., Kanai M., Uesaka K., Oda K., Rossi R.L., Braasch J.W., Dugan J.M. Management of hilar cholangiocarcinoma: comparison of an American and a Japanese experience. Ann. Surg. 2000; 232: 166–174.
37. Soares K.C., Kamel I., Cosgrove D.P., Herman J.M., Pawlik T.M. Hilar cholangiocarcinoma: diagnosis, treatment options, and management. Hepatobiliary Surg. Nutr. 2014; 3: 18–34. DOI: 10.3978/j.issn.2304-3881.2014.02.05.
38. Каштанова Н.Ю., Плетнева В.Ю., Гепалова Ю.Ю, Современный взгляд на проблему диагностики опухоли Клатскина (обзор литературы). Медицинская визуализация. 2016; 6: 52–61.
39. Jarnagin W.R., Fong Y., DeMatteo R.P., Gonen M., Burke E.C., Bodniewicz B.S.J, Youssef B.A.M., Klimstra D., Blumgart L.H. Staging, resectability, and outcome in 225 patients with hilar cholangiocarcinoma. Ann. Surg. 2001; 234: 507–517.
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For citations:
Shchegolev A.I., Tumanova U.N., Karmazanovsky G.G., Mishnev O.D. Cholangiocarcinoma: classification and staging. Medical Visualization. 2018;(5):55-64. (In Russ.) https://doi.org/10.24835/1607-0763-2018-5-55-64
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