Tumor necrosis impacts prognosis of patients undergoing resection for T1 intrahepatic cholangiocarcinoma: implications for modification of 8th AJCC T classification

Presenter: Diamantis Tsilimigras MD | The Ohio State University Background: Tumor necrosis has been associated with unfavorable prognosis among patients hepatocellular carcinoma and hilar cholangiocarcinoma. prognostic impact of tumor undergoing resection for intrahepatic cholangiocarcinoma (ICC) remains ill-defined. Methods: Patients who underwent curative-intent ICC between 2000-2017 were identified using an international multi-institutional database. association (absent, moderate [50%]) clinicopathologic characteristics the on overall (OS) recurrence-free survival (RFS) examined. Results: Among 757 ICC, was present in 384 (50.7%) (no necrosis: n=373, 49.3%, < 50% n=291, 38.4%, > n=93, 12.3%). characteristics, including size 5 cm (necrosis vs no necrosis; 67.4% 57.6%), CA19-9 200 ng/mL (35.5% 26.0%), liver capsule involvement (43.7% 19.8%) poor/undifferentiated grade (32.8% 21.8%) (all p<0.05). worse OS (5-year OS; 39.3% 34.7% 24.0%, p=0.03) RFS RFS: 25.7% 13.9% 18.8%, p<0.001). After stratifying by T stage, able to further stratify T1a RFS; & 46.7% 36.1%, p=0.02), T1b 31.1% 11.2%, p=0.006), but not outcomes more advanced T2-T4 disease. had similar as individuals 36.1% 31.1%, p=0.66) (Figure) Conclusion: T1 ICC. A modified AJCC classification that incorporates should be considered early T-stage