Current status of intrahepatic cholangiocarcinoma

Table 1 Staging system for ICC proposed by Liver Cancer Study Group of Japan

T1: Meet requirements (single nodule, tumor 2 cm or less and no portal vein, hepatic vein and serous membrane invasion)
T2: Meet two of the three requirements
T3: Meet one of the three requirements
T4: Meet none of the three requirements
N1: No metastasis to lymph node
N2: Metastasis to any lymph nodes
M0: No distant metastasis
M1: Positive distant metastasis
Stage I	T1	N0	M0
Stage II	T2	N0	M0
Stage III	T3	N0	M0
Stage IVA	T4	N0	M0
	Or any T	N1	M0
Stage IVB	Any T	Any N	M1

Table 2 Lymph node groups by tumor location

	N1	N2	N3
Right lobe	Hepatoduodenal ligament	Along left gastric artery	Distant
		Along common hepatic artery
		Along celiac artery
		Posterior surface of pancreas head
Left lobe	Right cardiac region	Along left gastric artery
	Lesser curvature of stomach	Along common hepatic artery
		Along celiac artery	Distant
	Hepatoduodenal ligament	Posterior surface of pancreas head

N3 distant: Abdominal aorta, root of the mesentery, inferior vena cava, etc.

Table 3 Comparison of recent series

Authors	Yr	Countries	Procedure (patients)	Prognosis (%)				Tumor recurrence (%)
				Median (mo)	1 yr	3 yr	5 yr
Pichlmayr et al[88]	1995	Germany	Hepatic resection (32)	12.8
			Liver transplantation (18)	5.0
Casavilla et al[89]	1997	America	Hepatic resection (34)		60	37	31	56
			Liver transplantation (20)		70	29	18	55
Chu et al[22]	1997	Hong Kong, China	Conservative management (15)	1.8
			Palliative operation (23)	2.9
			Hepatic resection (39)	12.2	57.3	23.9	15.9
Madariaga et al[98]	1998	Japan	Hepatic resection (34)	19	67	40	35
Meyer et al[99]	2000	America	Liver transplantation (207)		72	48 (2 yr)	23	51
Kawarada et al[100]	2001	Japan	hepatic resection (37)	31.5	54.1	34	23.9
Fu et al[101]	2004	China	Palliative or curative operation (79)	11.9	49.4	17.3	9.6
Robles et al[102]	2004	Spain	Liver transplantation (23)		77	65	42	35
Lang et al[80]	2005	Germany	R0-resection (complete tumor removal) (16)	46	94	82		37.5
			R1-resection (microscopic tumor at the cutting margin) (11)	5	22	0
Ghali et al[103]	2005	Canada	Liver transplantation (10)		90	80	20	80
Urahashi et al[104]	2007	Japan	HPD (hepatectomy with pancreatoduodenectomy) (12)		42	33	33	75
De Oliveira et al[105]	2007	America	Hepatic resection (R0-resection)	80			63
			Hepatic resection (overall)	28			40
Becker et al[106]	2008	America	Liver transplantation (280)		74		38