A new staging system for intrahepatic cholangiocarcinoma (ICC) that includes criteria such as a tumor cutoff size of 2 cm and major biliary invasion may be more effective at stratifying survival of patients and determining which of them to assign to surgery, according to a Japanese study published online ahead of print in Cancer.1

Researchers led by Yoshihiro Sakamoto, MD, PhD, of The Tokyo University Hospital examined 756 patients who had undergone surgical resection for ICC between 2000 and 2005.

The study’s objective was to propose a new staging system for ICC that would better stratify patient survival based on data from the nationwide Liver Cancer Study Group of Japan database.

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Multivariate analyses of clinicopathologic factors was performed on 419 of those patients who had complete data sets to be included in a new tumor classification and staging system.

Five-year survival rate in 15 patients who had ICC measuring 2 cm or less in greatest dimension without lymph node metastasis or vascular invasion was 100%.

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Upon multivariate analysis of prognostic factors in 267 patients with lymph node-negative and metastasis-negative disease, number of tumors, presence of arterial invasion, and presence of major biliary invasion were found to be independent and significant prognostic factors.

Under the proposed system, which included factors such as tumor number, tumor size, arterial invasion, and major biliary invasion for tumor classification, the researchers found that it provided good stratification of overall patient survival that corresponded with disease stage.


  1. Sakamoto Y, Kokudo N, Matsuyama Y, et al. Proposal of a new staging system for intrahepatic cholangiocarcinoma: analysis of surgical patients from a nationwide survey of the Liver Cancer Study Group of Japan. [published online ahead of print October 2, 2015].  Cancer. doi: 10.1002/cncr.29686.