Okabayashi et al identified prognostic factors for patients with intrahepatic cholangiocarcinoma. They used these to develop a TNM staging system which can help stratify patients. The authors are from the National Cancer Center Hospital and University of Tokyo in Tokyo, Japan.
Parameters serving as independent negative prognostic factors:
(1) hepatic regional lymph node metastasis
(2) presentation with multiple tumors
(3) symptomatic tumor
(4) presence of vascular invasion
I would imagine distant metastasis could be added to this list.
Based on these findings, the authors proposed the following staging system.
|
Classification |
Finding |
Designation |
|
T |
solitary tumor without vascular invasion |
T1 |
|
|
solitary tumor with vascular invasion |
T2 |
|
|
multiple tumors with or without vascular invasion |
T3 |
|
N |
no metastases to regional lymph nodes |
N0 |
|
|
metastases to regional lymph nodes |
N1 |
|
M |
no distant metastases |
M0 |
|
|
distant metastases present |
M1 |
|
TNM |
Stage |
Median Survival |
3 Year Survival |
|
T1 N0 M0 |
I |
> 10 years |
74% |
|
T2 N0 M0 |
II |
26.2 months |
48% |
|
T3 N0 M0 |
IIIA |
16.8 months |
18% |
|
any T, N1, M0 |
IIIB |
11.2 months |
7% |
|
any T, any N, M1 |
IV |
NA but short |
NA but poor |
where:
• Survival is based on time of hepatectomy if resectable.
Specialty: Hematology Oncology, Surgery, general, Gastroenterology
ICD-10: ,
