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Related Experiment Video

Updated: Jun 9, 2026

The Influence of Liver Resection on Intrahepatic Tumor Growth
07:55

The Influence of Liver Resection on Intrahepatic Tumor Growth

Published on: April 9, 2016

Tumour burden predicts outcomes after curative resection of multifocal intrahepatic cholangiocarcinoma.

Jun Kawashima1,2, Miho Akabane1, Mujtaba Khalil1

  • 1Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio, USA.

The British Journal of Surgery
|March 29, 2025
PubMed
Summary
This summary is machine-generated.

Stratifying multifocal intrahepatic cholangiocarcinoma (ICC) patients by tumour burden score (TBS) can identify those likely to benefit from liver resection. Low TBS multifocal ICC patients show survival similar to solitary ICC, while high TBS indicates a poor prognosis.

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Intraoperative Strategy under Complex Vascular Adhesion for Laparoscopic Radical Resection of Bismuth-Corlette Type IIIb Perihilar Cholangiocarcinoma

Published on: February 13, 2026

Area of Science:

  • Hepatobiliary surgery
  • Surgical oncology
  • Gastroenterology

Background:

  • Multifocal intrahepatic cholangiocarcinoma (ICC) presents a poor prognosis due to aggressive tumor biology, making liver resection controversial.
  • Identifying patients who can benefit from resection is crucial for improving outcomes in multifocal ICC.

Purpose of the Study:

  • To stratify multifocal ICC patients based on tumor burden.
  • To identify prognostic factors for overall survival (OS) in multifocal ICC.
  • To guide surgical decision-making and optimize treatment strategies.

Main Methods:

  • Analysis of patients undergoing curative-intent hepatectomy for ICC from an international multi-institutional database.
  • Multivariable Cox regression to identify prognostic factors for OS in multifocal tumors.
  • Tumor Burden Score (TBS) used for stratification, with optimal cut-off determined by restricted cubic spline (RCS) analysis.

Main Results:

  • Of 1502 patients, 208 (13.8%) had multifocal ICC. Independent prognostic factors included TBS, ASA grade, cirrhosis, morphological subtype, and adjuvant chemotherapy.
  • RCS analysis identified a TBS of 7.0 as the optimal cut-off.
  • Low TBS (<7.0) multifocal ICC patients had 3-year OS comparable to solitary ICC (AJCC stage II/III), while high TBS (≥7.0) multifocal ICC patients had the worst prognosis (17.8% 3-year OS).

Conclusions:

  • Patients with high-TBS multifocal ICC have a poor prognosis.
  • Individuals with low-TBS multifocal ICC demonstrate survival outcomes comparable to solitary ICC patients.
  • Stratification by tumor burden is essential for guiding surgical decisions and optimizing treatment for multifocal ICC.