Evidence map›Paper›PMID 40842313›Full record

ArticleJournal of surgical oncology2025

Characteristics of "Very Early" Intrahepatic Cholangiocarcinoma Undergoing Liver Resection and Its Relationship With Carbohydrate Antigen 19-9.

Yutaka Endo, Jun Kawashima, Selamawit Woldesenbet, Miho Akabane, Andrea Ruzzente, Luca Aldrighetti, Matthew J Weiss, Todd W Bauer, Irinel Popescu, George A Poultsides and 10 more

Abstract readMulticenter Study
In one paragraph

Article in Journal of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Present and future of liver transplantation for cholangiocellular carcinoma: moving toward personalized multiparametric transplantability patterns.Transplant international : official journal of the European Society for Organ Transplantation · 2026
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Yutaka EndoDepartment of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio, USA.
Jun KawashimaDepartment of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio, USA.
Selamawit WoldesenbetDepartment of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio, USA.
Miho AkabaneDepartment of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio, USA.
Andrea RuzzenteDepartment of Surgery, University of Verona, Verona, Italy.
Luca AldrighettiDepartment of Surgery, Ospedale San Raffaele, Milan, Italy.
Matthew J WeissDepartment of Surgery, Northwell Health, New Hyde Park, New York, USA.
Todd W BauerDepartment of Surgery, University of Virginia, Charlottesville, Virginia, USA.
Irinel PopescuDepartment of Surgery, Fundeni Clinical Institute, Bucharest, Romania.
George A PoultsidesDepartment of Surgery, Stanford University, Stanford, California, USA.
Minoru KitagoDepartment of Surgery, Keio University, Tokyo, Japan.
Federico AucejoHepato‑Pancreato‑Biliary and Liver Transplant Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Hugo P MarquesDepartment of Surgery, Curry Cabral Hospital, Lisbon, Portugal.
Guillaume MartelDepartment of Surgery, University of Ottawa, Ottawa, Ontario, Canada.
Carlo PulitanoDepartment of Surgery, Royal Prince Alfred Hospital, University of Sydney, Sydney, Australia.
Feng ShenDepartment of Surgery, Eastern Hepatobiliary Surgery Hospital, Shanghai, China.
François CauchyDepartment of Hepatobiliopancreatic Surgery, APHP, Beaujon Hospital, Clichy, France.
Bas Groot KoerkampDepartment of Surgery, Erasmus University Medical Centre, Rotterdam, The Netherlands.
Itaru EndoDepartment of Gastroenterological Surgery, Yokohama City University School of Medicine, Yokohama, Japan.
Timothy M PawlikDepartment of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio, USA.ORCID https://orcid.org/0000-0002-7994-9870

Funding

The authors received no specific funding for this work.
6 · The paper itself

Abstract

introductionThe concept of "very early" ICC ( ≤ 2 cm, single tumor) has been introduced in the context of LT. Due to the limited number of patients in this subset, the characteristics and long-term outcomes have been ill-defined. We sought to assess long-term outcomes of very early ICC patients undergoing liver resection using a large, multi-institutional database.

methodsPatients who underwent curative-intent hepatectomy for ICC between 1993 and 2023 were identified from the International Intrahepatic Cholangiocarcinoma Study Group database. Multivariable Cox regression analysis was performed to identify the risk factors related to overall survival (OS) and recurrence-free survival (RFS).

resultsAmong 1868 ICC patients, 86 (4.6%) met the criteria for very early ICC. While patient and tumor characteristics were similar between very early and non-very early ICC, 1-, 3-, and 5-year OS among patients with very early ICC was 92.3% (IQR 86.6-98.4), 72.6% (IQR 62.7-84.1), and 58.0% (IQR 45.9-73.5), respectively, versus 80.8% (IQR 78.9-82.7), 51.0% (IQR 48.4-53.8), and 38.9% (IQR 36.1-41.9), respectively, among non-very early ICC patients (p < 0.01). On multivariable Cox regression analysis, elevated CA19-9 levels were associated with worse OS (HR 3.05, IQR 1.28-7.30, p = 0.01) and RFS (HR 2.88, IQR 1.24-6.66, p = 0.01). Very early ICC patients with higher CA19-9 level were more likely to have metastatic nodal disease (N1: ≥ 40 U/mL n = 11, 40.7%, vs. n = 3, 5.1%, p < 0.001), microvascular invasion ( ≥ 40 U/mL n = 10, 37.0%, vs. n = 4, 6.8%, p < 0.001), and major vascular invasion ( ≥ 40 U/mL n = 8, 29.6%, vs. n = 2, 3.4%, p < 0.01).

conclusionsVery early ICC was associated with favorable long-term outcomes; however, elevated CA19-9 levels identified a subgroup with a much worse prognosis and more aggressive tumor features. CA19-9 may help guide perioperative treatment decisions, including additional treatment after surgical interventions.

Indexed as

Bile Duct NeoplasmsCA-19-9 AntigenCholangiocarcinomaHepatectomyAgedFemaleFollow-Up StudiesHumansMaleMiddle AgedPrognosisRetrospective StudiesSurvival RateCA-19-9 AntigenCA19‐9intrahepatic cholangiocarcinomaliver resection

Identifiers

PMID40842313
PMCPMC12501924

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.