Cholangiocarcinoma (staging)
Updates to Synonym Attributes
Updates to Article Attributes
Cholangiocarcinoma staging classifications vary depending on whether the tumour is primarily intrahepatic (ICC), hilar/perihilar (Klatskin), or extrahepatic. Resection
Tumour resection is currently the most optimal treatment and the ability of the tumour to infiltrate longitudinally and radially along the biliary tree necessitates aggressive resection strategies such as ipsilateral hepatectomy.
Intrahepatic cholangiocarcinoma (ICC) staging
ICC staging follows the more traditional "TNM" staging model for epithelial tumours 1. Lymph node metastases and extrahepatic metastases are much more likely than with hepatocellular carcinoma.
Current staging classifications include:
Variables used in these systems include
- tumour size (>2 cm)
- multiple tumours
- bilaterality of tumours
- vascular invasion (micro and/or macro)
Perihilar/hilar cholangiocarcinoma staging
The problem with traditional TNM staging for hilar cholangiocarcinoma is that a small, badly place tumour markedly worsenedworsens prognosis, and T staging was inadequate. Traditionally, the Bismuth-Corlette classification (developed in 1975) was an anatomic description used to assesassess resectability of hilar/perihilar cholangiocarcinoma 2. However this This classification is useful but has been modified over time.
Current staging classifications include:
- MSKCC system for staging cholangiocarcinoma
- AJCC system (7th edition) for staging cholangiocarcinoma
Important features common to both assessments include:
- hepatic duct involvement (unilateral vs. bilateral)
- portal vein involvement (ipsilateral vs contralateral vs. main)
Other variables include:
- ipsilateral hepatic hemiatrophy
- tumour extension into second order biliary radicles
- tumour extension into surrounding adipose tissue or hepatic parenchyma
- hepatic artery involvement (ipsilateral vs contralateral vs. common hepatic artery)
- regional lymph node metastases
Exrahepatic cholangiocarcinoma staging
content pending
Pathology
Poorer prognosis has also been associated with: 3,4
- worse histological grade of the tumour
- increased CA-19-9
- increased CEA
-<p><strong><a title="Cholangiocarcinoma" href="/articles/cholangiocarcinoma">Cholangiocarcinoma</a> staging</strong> classifications vary depending on whether the tumour is primarily intrahepatic (ICC), <a title="Klatskin tumour" href="/articles/klatskin-tumour">hilar/perihilar (Klatskin)</a>, or extrahepatic. Resection is the most optimal treatment and the ability of the tumour to infiltrate longitudinally and radially along the biliary tree necessitates aggressive resection strategies such as ipsilateral hepatectomy.</p><h5>Intrahepatic cholangiocarcinoma (ICC) staging</h5><p>ICC staging follows the more traditional "TNM" staging model for epithelial tumours <sup>1</sup>. Lymph node metastases and extrahepatic metastases are much more likely than with <a title="Hepatocellular carcinoma (HCC)" href="/articles/hepatocellular-carcinoma">hepatocellular carcinoma</a>.</p><p>Current staging classifications include:</p><ul>-<li><a title="UICC system" href="/articles/uicc-system">UICC system</a></li>-<li><a title="Okabayashi system" href="/articles/okabayashi-system">Okabayashi system</a></li>- +<p><strong><a href="/articles/cholangiocarcinoma">Cholangiocarcinoma</a> staging</strong> classifications vary depending on whether the tumour is primarily intrahepatic (ICC), <a href="/articles/klatskin-tumour">hilar/perihilar (Klatskin)</a>, or extrahepatic.</p><p>Tumour resection is currently the most optimal treatment and the ability of the tumour to infiltrate longitudinally and radially along the biliary tree necessitates aggressive resection strategies such as ipsilateral hepatectomy.</p><h5>Intrahepatic cholangiocarcinoma (ICC) staging</h5><p>ICC staging follows the more traditional "TNM" staging model for epithelial tumours <sup>1</sup>. Lymph node metastases and extrahepatic metastases are much more likely than with <a href="/articles/hepatocellular-carcinoma">hepatocellular carcinoma</a>.</p><p>Current staging classifications include:</p><ul>
- +<li><a href="/articles/uicc-system">UICC system</a></li>
- +<li><a href="/articles/okabayashi-system">Okabayashi system</a></li>
-</ul><h5>Perihilar/hilar cholangiocarcinoma staging</h5><p>The problem with traditional TNM staging for hilar cholangiocarcinoma is that a small, badly place tumour markedly worsened prognosis, and T staging was inadequate. Traditionally, the <a href="/articles/bismuth-corlette-classification">Bismuth-Corlette classification</a> (developed in 1975) was an anatomic description used to asses resectability of hilar cholangiocarcinoma <sup>2</sup>. However this classification has been modified.</p><p>Current staging classifications include:</p><ul>-<li><a title="MSKCC system for staging cholangiocarcinoma" href="/articles/mskcc-system-for-staging-cholangiocarcinoma">MSKCC system for staging cholangiocarcinoma</a></li>-<li><a title="AJCC system (7th edition) for staging cholangiocarcinoma" href="/articles/ajcc-system-7th-edition-for-staging-cholangiocarcinoma">AJCC system (7th edition) for staging cholangiocarcinoma</a></li>- +</ul><h5>Perihilar/hilar cholangiocarcinoma staging</h5><p>The problem with traditional TNM staging for hilar cholangiocarcinoma is that a small, badly place tumour markedly worsens prognosis, and T staging was inadequate. Traditionally, the <a href="/articles/bismuth-corlette-classification">Bismuth-Corlette classification</a> (developed in 1975) was an anatomic description used to assess resectability of hilar/perihilar cholangiocarcinoma <sup>2</sup>. This classification is useful but has been modified over time.</p><p>Current staging classifications include:</p><ul>
- +<li><a href="/articles/mskcc-system-for-staging-cholangiocarcinoma">MSKCC system for staging cholangiocarcinoma</a></li>
- +<li><a href="/articles/ajcc-system-7th-edition-for-staging-cholangiocarcinoma">AJCC system (7th edition) for staging cholangiocarcinoma</a></li>
References changed:
Tags changed:
- liver
- liver mri
- cholangiocarcinoma
- staging
- cases
Sections changed:
- Staging
Systems changed:
- Hepatobiliary