| 論文種別 | 原著(症例報告除く) |
| 言語種別 | 英語 |
| 査読の有無 | その他(不明) |
| 表題 | Proposal and external validation of a prognosis-oriented TNM staging system for intrahepatic cholangiocarcinoma: A multicenter study from the Kansai region of Japan. |
| 掲載誌名 | 正式名：Surgery 略 称：Surgery ISSNコード：15327361/00396060 |
| 掲載区分 | 国外 |
| 巻・号・頁 | 191,pp.110051 |
| 著者・共著者 | Yusuke Yamamoto, Hisashi Kosaka, Masaki Ueno, Hiroji Shinkawa, Satoshi Yasuda, Koji Komeda, Haruki Mori, Tsukasa Aihara, Shinya Hayami, Masahiko Kinoshita, Nao Kawaguchi, Atsushi Shiozaki, Takeaki Ishizawa, Shoji Kubo, Masaki Kaibori |
| 発行年月 | 2026/03 |
| 概要 | INTRODUCTION:The American Joint Committee on Cancer staging insufficiently reflects the prognosis of intrahepatic cholangiocarcinoma.METHODS:Overall, 496 patients from 8 hospitals in the Kansai region (2006-2023) were analyzed. A training set of 405 patients was used to construct the modified TNM staging, and a validation set of 91 patients was used to evaluate its performance.RESULTS:In the training set, 5-year survival rates exceeded 80% for intraductal growth-type tumors ≤50 mm and mass-forming or periductal infiltrating-type tumors ≤20 mm without vascular invasion, supporting their classification as T1. Extrahepatic vascular invasion, including involvement of the left, right, or main portal vein (median survival time, 16.2 months), inferior vena cava (9.0 months), or hepatic artery (8.4 months), was classified as T4. Tumors with prognostic factors in the multivariate analysis (tumor size >5 cm, vascular invasion, and multifocality [marginally significant]) were classified as T3, whereas tumors measuring 2-5 cm without these factors were classified as T2. Lymph node metastasis was classified as N0 (0 nodes, median survival time: 57.6 months), N1 (1-3 nodes, 22.5 months), and N2 (≥4 nodes, 11.2 months). The stages were defined as follows: IA (T1N0M0), IB (T2N0M0), II (T3N0M0), III (T4N0M0 or anyTN1M0), IVA (anyTN2M0), and IVB (M1). In the validation set, the American Joint Committee on Cancer staging showed overlapping survival for T1b-T4, whereas the new staging stratified survival well.CONCLUSION:The proposed staging showed better prognostic stratification than the American Joint Committee on Cancer staging and was validated in an independent cohort. |
| DOI | 10.1016/j.surg.2025.110051 |
| PMID | 41539163 |