Comparison of concomitant and subsequent cholangiocarcinomas associated with hepatolithiasis: Clinical implications

Table 1 Clinical characteristics of patients

	C-CCA group	S-CCA group	P value
Incidence (%)	10/211 (4.7)	12/197 (6.1)	0.546
Unilateral stones	8/168 (4.8)	7/156 (4.5)	0.906
Bilateral stones	2/43 (4.7)	5/41 (12.2)	0.211
Age, yr (range)	61 (39-82)	59 (46-69)	0.742
Gender (%)
Male	1 (10)	1 (8.3)	0.892
Female	9 (90)	11 (91.7)
Mean interval from operation to CCA, mo (range)	-	67 (7-138)	-
Mean interval from CCA to disease-related death, mo (range)	41 (3-107)	4 (0-13)	0.075
Follow-up time, mo (range)	56 (2-140)	71 (7-144)	0.291
Mortality, n (%)
Overall	7 (70)	12 (100)	0.041
Disease-related	6 (60)	12 (100)	0.015

C-CCA: Concomitant cholangiocarcinoma; S-CCA: Subsequent cholangiocarcinoma; CCA: Cholangiocarcinoma.

Table 2 Summary of patients with concomitant cholangiocarcinoma

Case	Age/sex	Stone location	Procedure	Residual/recurrent stones	Margin	pTNM	Interval from CCA to death (mo)
89	50/F	R	S5/6/7	-/-	Free	T1 N1 M0	3
90	68/F	L	LH	-/-	Free	T1 Nx M0	Alive (140)
119	82/F	L	LL	-/-	Atypical mucinous epithelium	T1 Nx M0	73
128	60/M	L	LH	-/-	Free	T1 N0 M0	3 (hypopharyngeal tumor)
142	39/F	L	LL	-/-	Free	T4 N1 M0	3
212	76/F	L	S2	-/-	Inadequate	T1 Nx M0	56
227	61/F	L	LH + RA	-/+	Free	T1 N0 M0	107 (re-operated 4 years later due to CCA recurrence at CBD)
253	72/F	L	LH	-/-	Free	T1 N0 M0	Alive (49)
143	50/F	BI	LH + S5	-/+	Free	T1 Nx M0	Alive (119) (re-operated 5 years later due to CCA recurrence at CBD)
217	56/F	BI	RH	+/-	Inadequate	T2a Nx M0	5

L: Left; R: Right; BI: Bilateral; LH: Left hemihepatectomy; LL: Left lateral sectionectomy; RH: Right hemihepatectomy; RA: Right anterior sectionectomy; S5: Segment 5; S2: Segment 2; CCA: Cholangiocarcinoma; CBD: Common bile duct; pTNM: Pathologic TNM stage for intrahepatic bile duct according to AJCC 7th edition; F: Female; M: Male.

Table 3 Summary of patients with subsequent cholangiocarcinoma

Case	Age/sex	Stone location	Procedure	Residual/recurrent stones	Interval from hepatectomy to S-CCA (mo)	Second hepatectomy for S-CCA	Interval S-CCA to death (mo)
1	56/F	L	LH	- / -	87	No	< 1
11	59/F	R	S5/6	- / -	91	Yes	4
						(with involved surgical margin)
66	65/F	R	RH	- / +	114	No	6
69	61/F	R	RP	- / +	67	No	3
137	69/F	L	LL	- / -	95	No	2
203	60/F	L	LH	- / -	47	No	13
236	63/F	L	LL	- / -	7	No	< 1
37	46/F	BI	LL	- / -	138	No	6
96	65/F	BI	LL + S6	- / -	115	No	2
157	53/F	BI	LL + S6	- / -	19	No	4
159	63/F	BI	LL	+ / -	19	No	6
163	50/M	BI	LH	+ / -	10	No	2

L: Left; R: Right; BI: Bilateral; S6: Segment 6; LH: Left hemihepatectomy; LL: Left lateral sectionectomy; RH: Right hemihepatectomy; RP: Right posterior sectionectomy; S-CCA: Subsequent cholangiocarcinoma; F: Female; M: Male.