Korean J Hepatobiliary Pancreat Surg.  2015 Nov;19(4):167-172. 10.14701/kjhbps.2015.19.4.167.

Bile duct invasion can be an independent prognostic factor in early stage hepatocellular carcinoma

• Jang YR
• Lee KW
• Kim H
• Lee JM
• Yi NJ
• Suh KS

• KMID: 2130969
• DOI: http://doi.org/10.14701/kjhbps.2015.19.4.167

Abstract

BACKGROUNDS/AIMS
In hepatocellular carcinoma (HCC), bile duct invasion occurs far more rarely than vascular invasion and is not well characterized. In addition, the pathologic finding of bile duct invasion is not considered an independent prognostic factor for HCC following surgery. In this study, we determined the characteristics of HCC with bile duct invasion, and assessed the clinical significance of bile duct invasion.
METHODS
We retrospectively reviewed the medical records of 363 patients who underwent hepatic resection for HCC at Seoul National University Hospital (SNUH) from January 2009 to December 2011. Preoperative, operative, and pathological data were collected. The risk factors for recurrence and survival were analyzed. Subsequently, the patients were divided into 2 groups according to disease stage (American Joint Committee on Cancer/International Union Against Cancer 7th edition): early stage (T1 and 2) and advanced stage (T3 and 4) group; and risk factors in the sub-groups were analyzed.
RESULTS
Among 363 patients, 13 showed bile duct invasion on pathology. Patients with bile duct invasion had higher preoperative total bilirubin levels, greater microvascular invasion, and a higher death rate than those without bile duct invasion. In multivariate analysis, bile duct invasion was not an independent prognostic factor for survival for the entire cohort, but, was an independent prognostic factor for early stage.
CONCLUSIONS
Bile duct invasion accompanied microvascular invasion in most cases, and could be used as an independent prognostic factor for survival especially in early stage HCC (T1 and T2).

Keyword

Hepatocellular carcinoma; Bile duct invasion

MeSH Terms

Bile Ducts*
Bile*
Bilirubin
Carcinoma, Hepatocellular*
Cohort Studies
Humans
Joints
Medical Records
Mortality
Multivariate Analysis
Pathology
Recurrence
Retrospective Studies
Risk Factors
Seoul
Bilirubin

Figure

• 

  Fig. 1 Correlation between overall survival and bile duct invasion in early stage HCC patients (T-stage 1 and 2).

• 

  Fig. 2 Correlation between overall survival and bile duct invasion in advanced stage HCC patients (T-stage 3 and 4).

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