• Humans
• Carcinoma, Hepatocellular/surgery
• Carcinoma, Hepatocellular/mortality
• Carcinoma, Hepatocellular/pathology
• Liver Neoplasms/surgery
• Liver Neoplasms/mortality
• Liver Neoplasms/pathology
• Propensity Score
• Male
• Female
• Middle Aged
• Hepatectomy/adverse effects
• Hepatectomy/methods
• Retrospective Studies
• Neoplasm Staging
• Aged
• China/epidemiology
• Adult

• circular RNAs (circRNAs)
• cytotoxic T lymphocytes
• hepatocellular carcinoma (HCC)
• immunotherapy
• natural killer cells
• tumor microenvironment (TME)

• Humans
• Carcinoma, Hepatocellular/genetics
• Carcinoma, Hepatocellular/therapy
• RNA, Circular/genetics
• Liver Neoplasms/genetics
• Liver Neoplasms/therapy
• Immunotherapy
• Biomarkers, Tumor/genetics
• Tumor Microenvironment/genetics

• hepatocellular carcinoma
• prediction
• recurrence
• resection

• Humans
• Carcinoma, Hepatocellular
• Liver Neoplasms/pathology
• Prognosis
• Retrospective Studies
• Postoperative Period
• Neoplasm Recurrence, Local/pathology
• Hepatectomy

• AFP
• ALBI grade
• Hepatocellular carcinoma
• Operation time

• HCC
• NCF2
• TCGA
• TME
• prognosis

We conduct this study to investigate the value of Kupffer phase radiomics signature of Sonazoid-enhanced ultrasound images (SEUS) for the preoperative prediction of hepatocellular carcinoma (HCC) grade. From November 2019 to October 2021, 68 pathologically confirmed HCC nodules from 54 patients were included. Quantitative radiomic features were extracted from grayscale images and arterial and Kupffer phases of SEUS of HCC lesions. Univariate logistic regression and the maximum relevance minimum redundancy (MRMR) method were applied to select radiomic features best corresponding to pathological results. Prediction radiomic signature was calculated using each of the image types. A predictive model was validated using internal leave-one-out cross validation (LOOCV). For discrimination between poorly differentiated HCC (p-HCC) and well-differentiated HCC/moderately differentiated HCC (w/m-HCC), the Kupffer phase radiomic score (KPRS) achieved an excellent area under the curve (AUC = 0.937), significantly higher than the other two radiomic signatures. KPRS was the best radiomic score based on the highest AUC (AUC = 0.878), which is prior to gray and arterial RS for differentiation between w-HCC and m/p-HCC. Univariate and multivariate analysis incorporating all radiomic signatures and serological variables showed that KPRS was the only independent predictor in both predictions of HCC lesions (p-HCC vs. w/m-HCC, log OR 15.869, P < 0.001, m/p-HCC vs. w-HCC, log OR 12.520, P < 0.05). We conclude that radiomics signature based on the Kupffer phase imaging may be useful for identifying the histological grade of HCC. The Kupffer phase radiomic signature may be an independent and effective predictor in discriminating w-HCC and p-HCC.

Non-B, non-C hepatocellular carcinoma (NBNC-HCC) may be related to metabolic syndrome, and the incidence of this tumor type is increasing annually. The definition of metabolic-associated fatty liver disease (MAFLD) proposed in 2020 may help to more accuratelyassess the association between metabolic syndrome and NBNC-HCC. However, this new concept has not yet been applied in NBNC-HCC research. Therefore, this study aimed to compare the clinicopathological characteristics of patients with NBNC-HCC and CHB-HCC diagnosed between 2009-13 and 2014-18, focusing on metabolic risk factors and the new concept of MAFLD.

Patients with BCLC-0/A-HCC who received curative hepatectomy between January 2009 and December 2018 were retrospectively assessed; the associations between clinicopathological characteristics and clinical outcomes of NBNC-HCC and CHB-HCC were analyzed by multivariate analysis.

Compared to patients diagnosed in 2009-13, the frequency of metabolic disorders in NBNC-HCC was significantly higher in 2014-18 [DM (p=0.049), HTN (p=0.004), BMI (p=0.017) and MAFLD (p=0.003)]; there was no significant change in patients with CHB-HCC. Moreover, CHB-HCC was an independent risk factor for HCC recurrence (HR, 1.339; 95% CI, 1.010-1.775, p=0.043) and death (HR, 1.700; 95% CI, 1.017-2.842, p=0.043) compared to NBNC-HCC.

Therisk of MAFLD, obesity, DM, and hypertension in patients with early-stage NBNC have significantly increased in recent years, thus metabolic syndrome should be monitored in this special population. Moreover, NBNC-HCC tend to had a better prognosis than CHB-HCC, probably due to their distinct clinicopathological features.

• CHB
• NBNC
• hepatocellular carcinoma
• metabolic associated fatty liver disease (MAFLD)
• metabolic dysfunction
• recurrence

Recent studies have suggested that periportal location of percutaneous radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) is considered as one of the independent risk factors for local tumor progression (LTP). However, the long-term therapeutic outcomes of percutaneous RFA as the first-line therapy for single periportal HCCand corresponding impacts on tumor recurrence or progression are still unclear.

From February 2011 to October 2020, a total of 233 patients with single nodular HCC ≤ 5 cm who underwent RFA ± transarterial chemoembolization (TACE) as first-line therapy was enrolled and analyzed, including 56 patients in the periportal group and 177 patients in the nonperiportal group. The long-term therapeutic outcomes between the two groups were compared, risk factors of tumor recurrence or progression were evaluated.

The LTP rates at 1, 3, and 5 years were significantly higher in the periportal group than those in the nonperiportal group (15.7, 33.7, and 46.9% vs 6.0, 15.7, and 28.7%, respectively, P = 0.0067). The 1-, 3- and 5-year overall survival (OS) rates in the periportal group were significantly worse than those in the nonperiportal group (81.3, 65.1 and 42.9% vs 99.3, 90.4 and 78.1%, respectively, P<0.0001). In the subgroup of single HCC ≤ 3 cm, patients with periportal HCC showed significantly worse LTP P = 0.0006) and OS (P<0.0001) after RFA than patients with single nonperiportal HCC; The univariate and multivariate analyses revealed that tumor size, periportal HCC and AFP ≥ 400ug/ml were independent prognostic factors for tumor progression after RFA. Furthermore, patients with single periportal HCC had significantly higher risk for IDR(P = 0.0012), PVTT(P<0.0001) and extrahepatic recurrence(P = 0.0010) after RFA than those patients with single nonperiportal HCC. .

The long-term therapeutic outcomes of RFA as the first-line therapy for single periportal HCC were worse than those for single nonperiportal HCC, an increased higher risk of tumor recurrence or progression after RFA was significantly associated with periportal HCC.

The online version contains supplementary material available at 10.1186/s40644-021-00442-2.

• Hepatocellular carcinoma (HCC)
• Periportal
• Radiofrequency ablation (RFA)
• Therapeutic outcomes
• Tumor progression
• Tumor recurrence

Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related mortalities worldwide. Patients with early-stage HCC are eligible for curative treatments, such as surgical resection, liver transplantation (LT) and percutaneous ablation. Although curative treatments provide excellent long-term survival, almost 70–80% of patients experience HCC recurrence after curative treatments. Tumor-related factors, including tumor size, number and differentiation, and underlying liver disease, are well-known risk factors for recurrence following curative therapies. Moreover, the tumor microenvironment (TME) also plays a key role in the recurrence of HCC. Many immunosuppressive mechanisms, such as an increase in regulatory T cells and myeloid-derived suppressor cells with a decrease in cytotoxic T cells, are implicated in HCC recurrence. These suppressive TMEs are also modulated by several factors and pathways, including mammalian target of rapamycin signaling, vascular endothelial growth factor, programmed cell death protein 1 and its ligand 1. Based on these mechanisms and the promising results of immune checkpoint blockers (ICBs) in advanced HCC, there have been several ongoing adjuvant studies using a single or combination of ICB following curative treatments in HCC. In this review, we strive to provide biologic and immunological markers, prognostic factors, and challenges associated with clinical outcomes after curative treatments, including resection, LT and ablation.

• ablation
• hepatocellular carcinoma
• immune checkpoint blockers
• immune suppression
• liver transplantation
• outcomes
• recurrence
• resection
• tumor microenvironment

• Carcinoma, Hepatocellular/drug therapy
• Humans
• Liver Neoplasms/drug therapy
• Lymphocytes
• Phenylurea Compounds
• Prognosis
• Proportional Hazards Models
• Quinolines

Recurrence after curative resection for hepatocellular carcinoma (HCC) is a major cause of death from this disease. Factors of primary curative resection are available and potential in the prognosis of follow-up treatment. Our aim was to assess the prognostic significance of primary curative resection factors in recurrent HCC patients undergoing radiofrequency ablation therapy (RFA).

In this retrospective study, we assessed 235 patients who underwent limited RFA of HCC recurrences (tumors ≤ 5 cm; nodules ≤ 3) after primary curative resection. Factors of primary curative resection were collected, and overall survival and recurrence-free survival were evaluated by the Kaplan-Meier method. Univariate and multivariate analyses were used to identify significant prognostic factors.

After a median follow-up of 36 months, 54 patients died, and 128 patients had hepatic recurrence. On univariate analyses, patients whose primary tumors were less differentiated (p = 0.032 and p = 0.048) and required less time to recur (p = 0.013 and p = 0.001) after curative resection displayed poorer overall survival and higher recurrence rates following RFA. On multivariate analyses, the pathologic tumor grade (p = 0.026 and p = 0.038) and recurrence-free survival after primary curative resection (p = 0.028 and p < 0.001) emerged as independent risk factors of survival and HCC recurrence.

Primary tumor differentiation and time to recurrence after curative resection are viable prognostic factors of overall survival and further recurrence risk in patients undergoing RFA of recurrent HCC.

• Direct-acting antivirals
• Hepatic functional reserve
• Hepatitis C virus
• Hepatocellular carcinoma

• hepatectomy
• hepatitis C virus
• hepatocellular carcinoma
• regression of liver fibrosis
• sustained virologic response

Although hepatocellular carcinoma (HCC) is notorious for its high recurrence rate, some patients do not experience recurrence for more than 5 years after resection or radiofrequency ablation for early-stage HCC. For those with five recurrence-free period, the risk of HCC recurrence within the next 5 years remains unknown.

A total of 1,451 consecutive patients (median, 55 years old; males, 79.0%; hepatitis B virus-related, 79.3%) with good liver function (Child-Pugh class A) diagnosed with early-stage HCC by Barcelona Clinic Liver Cancer Staging and received radiofrequency ablation or resection as an initial treatment between 2005 and 2010 were analyzed.

During a median follow-up period of 8.1 years, 961 patients (66.2%) experienced HCC recurrence. The cumulative recurrence rates increased to 39.7%, 60.3%, and 71.0% at 2, 5, and 10 years, respectively, and did not reach a plateau. Five years after HCC diagnosis, 487 patients were alive without experiencing a recurrence. Among them, during a median of 3.9 additional years of follow-up (range, 0.1–9.0 years), 127 patients (26.1%) experienced recurrence. The next 5-year cumulative recurrence rate (5–10 years from initial diagnosis) was 27.0%. Male sex, higher fibrosis-4 scores, and alpha-fetoprotein levels at 5 years were associated with later HCC recurrence among patients who did not experience recurrence for more than 5 years.

The HCC recurrence rate following 5 recurrence-free years after HCC treatment was high, indicating that HCC patients warrant continued HCC surveillance, even after 5 recurrence-free years.

• Carcinoma, Hepatocellular
• Long-term
• Recurrence
• Treatment

• Hepatocellular carcinoma
• NTRK
• Prognosis
• Target
• Trk

To date, no standard follow-up guidelines exist regarding patients receiving ablation for initial recurrent hepatocellular carcinoma (HCC). We aimed to explore whether intensive follow-up could benefit these patients.

We reviewed the clinical data of patients who received complete ablation for initial HCC recurrence after curative treatments in our institution from January 2005 to June 2017. Risk factors for second recurrence of HCC were identified by univariate and multivariate analyses. Patients were classified into low- and high-risk groups according to the outcome of the classification and regression model. The patients were further categorized into short- (< 3 months) and long-interval (3–6 months) follow-up subgroups based on their surveillance in the first 2 years after complete ablation for initial recurrence. The Kaplan-Meier method with log-rank test was performed to compare the overall survival (OS) based on follow-up intervals in each risk group. We also validated our results by stratifying patients into subgroups with different numbers of risk factors and comparing the OS between patients with different follow-up intervals.

A total of 361 patients were enrolled. The risk factors for secondary recurrence included the Barcelona Clinic Liver Cancer (BCLC) stage at initial recurrence and first recurrence-free survival after curative treatments for primary HCC (p < 0.001 and p = 0.002). Two risk groups (low and high) were identified. In both the low- and high-risk groups, the OS of patients was not associated with intervals of follow-up (p = 0.29 and 0.49). No significant difference was found in the rates of BCLC 0/A stage, tumor location or curative treatments for the second recurrence by different follow-up intervals in each risk group (p = 0.34 and 0.87; p = 0.69 and 0.97). The same tendency was found in subgroups with 0/1/2 risk factors for secondary recurrence during validation.

The long-interval follow-up did not compromise the survival of patients with complete ablation for initial recurrent HCC.

• Ablation
• Follow-up
• Hepatocellular carcinoma
• Recurrence
• Survival

There is no established postoperative adjuvant therapy for hepatocellular carcinoma (HCC), and improvement of patient prognosis has been limited. We conducted long‐term monitoring of patients within a phase II trial that targeted a cancer antigen, glypican‐3 (GPC3), specifically expressed in HCC. We sought to determine if the GPC3 peptide vaccine was an effective adjuvant therapy by monitoring disease‐free survival and overall survival. We also tracked GPC3 immunohistochemical (IHC) staining, CTL induction, and postoperative plasma GPC3 for a patient group that was administered the vaccine (n = 35) and an unvaccinated patient group that underwent surgery only (n = 33). The 1‐y recurrence rate after surgery was reduced by approximately 15%, and the 5‐y and 8‐y survival rates were improved by approximately 10% and 30%, respectively, in the vaccinated group compared with the unvaccinated group. Patients who were positive for GPC3 IHC staining were more likely to have induced CTLs, and 60% survived beyond 5 y. Vaccine efficacy had a positive relationship with plasma concentration of GPC3; high concentrations increased the 5‐y survival rate to 75%. We thus expect GPC3 vaccination in patients with HCC, who are positive for GPC3 IHC staining and/or plasma GPC3 to induce CTL and have significantly improved long‐term prognosis.

• cytotoxic T lymphocyte
• glypican-3
• hepatocellular carcinoma
• immunohistochemical staining
• peptide vaccine

• hepatocellular carcinoma
• radiofrequency ablation
• serum tumour markers
• survival
• tumour recurrence

• Circulating tumour cell
• Hepatic resection
• Hepatocellular carcinoma
• Local therapy
• Safety margin

• Aged
• Aged, 80 and over
• Carcinoma, Hepatocellular/diagnostic imaging
• Carcinoma, Hepatocellular/etiology
• Carcinoma, Hepatocellular/surgery
• Craniofacial Dysostosis
• Disease-Free Survival
• Female
• Humans
• Limb Deformities, Congenital
• Liver/diagnostic imaging
• Liver Neoplasms/diagnostic imaging
• Liver Neoplasms/etiology
• Liver Neoplasms/surgery
• Magnetic Resonance Imaging/methods
• Male
• Middle Aged
• Neoplasm Recurrence, Local/diagnostic imaging
• Retrospective Studies
• Risk Factors

• Hepatocellular carcinoma
• Microscopic intrahepatic metastasis
• Potential multi-centric metastasis
• Receiver operating characteristic curve
• Tumor diameter

• Adult
• Aged
• Aged, 80 and over
• Carcinoma, Hepatocellular/blood supply
• Carcinoma, Hepatocellular/mortality
• Carcinoma, Hepatocellular/pathology
• Carcinoma, Hepatocellular/surgery
• Disease-Free Survival
• Female
• Hepatectomy
• Humans
• Liver Neoplasms/blood supply
• Liver Neoplasms/mortality
• Liver Neoplasms/pathology
• Liver Neoplasms/surgery
• Male
• Middle Aged
• Neoplasm Invasiveness
• Neoplasm Micrometastasis
• Prognosis
• Retrospective Studies
• Survival Rate
• Tumor Burden

• hepatitis C virus (HCV)
• hepatocellular carcinoma (HCC)
• recurrence
• survival
• sustained virological response (SVR)

• Aged
• Aged, 80 and over
• Antineoplastic Agents/therapeutic use
• Antiviral Agents/therapeutic use
• Carcinoma, Hepatocellular/mortality
• Carcinoma, Hepatocellular/therapy
• Case-Control Studies
• Female
• Hepatitis C, Chronic/complications
• Hepatitis C, Chronic/drug therapy
• Humans
• Interferons/therapeutic use
• Liver Neoplasms/therapy
• Male
• Middle Aged
• Recurrence
• Retrospective Studies
• Survival Analysis
• Sustained Virologic Response
• Treatment Outcome

• 17fk0310109h0001 Japan Agency for Medical Research and Development, AMED

Guidelines recommend surveillance for hepatocellular carcinoma (HCC) recurrence at 3-month intervals during the first year after curative treatment and 6-month intervals thereafter in all patients. This strategy does not reflect individual risk of recurrence. We aimed to stratify risk of recurrence to optimize surveillance intervals 1 year after treatment.

We retrospectively analyzed 1,316 HCC patients treated with resection/radiofrequency ablation at Barcelona Clinic Liver Cancer stage 0/ A. In patients without 1-year recurrence under 3-monthly surveillance, a new model for recurrence was developed using backward elimination methods: training (n=582)/ validation cohorts (n=291). Overall survival (OS) according to risk stratified by the new model was compared according to surveillance intervals: 3-monthly versus 6-monthly (n=401) after lead time bias correction and propensity-score matching analyses.

Among patients without 1-year recurrence, age and international normalized ratio values were significant factors for recurrence (hazard ratio [HR], 1.03; 95% confidence interval [CI], 1.00 to 1.03; p=0.009 and HR, 5.63; 95% CI, 2.24 to 14.18; p<0.001; respectively). High-risk patients stratified by the new model showed significantly higher recurrence rates than low-risk patients in the validation cohort (HR, 1.73; 95% CI, 1.18 to 2.53; p=0.005). After propensity-score matching between the 3-monthly and 6-monthly surveillance groups, OS in high-risk patients under 3-monthly surveillance was significantly higher than that under 6-monthly surveillance (p=0.04); however, OS in low-risk patients under 3-monthly surveillance was not significantly different from that under 6-monthly surveillance (p=0.17).

In high-risk patients, 3-monthly surveillance can prolong survival compared to 6-monthly surveillance. However, in low-risk patients, 3-monthly surveillance might not be beneficial for survival compared to 6-monthly surveillance.

• Carcinoma, hepatocellular
• Curative treatment
• Risk stratification
• Surveillance interval

• hepatocellular carcinoma
• locoregional therapy
• meta-analysis
• salvage liver transplantation

• Carcinoma, Hepatocellular/mortality
• Carcinoma, Hepatocellular/therapy
• Female
• Hepatectomy/adverse effects
• Hepatectomy/methods
• Humans
• Length of Stay/statistics & numerical data
• Liver Neoplasms/mortality
• Liver Neoplasms/therapy
• Liver Transplantation/adverse effects
• Liver Transplantation/methods
• Male
• Neoplasm Recurrence, Local/therapy
• Postoperative Complications/epidemiology
• Postoperative Complications/etiology
• Salvage Therapy/adverse effects
• Salvage Therapy/methods
• Survival Rate
• Treatment Outcome

• HCC
• hepatectomy
• nomogram
• percutaneous thermal ablation
• recurrent hepatocellular carcinoma

To evaluate contrast-enhanced ultrasound (CEUS) for monitoring early intrahepatic recurrence of primary hepatocellular carcinoma (HCC) after curative treatment.

We prospectively analyzed 97 patients (124 nodules) with primary HCC who underwent hepatic resection or radiofrequency ablation and subsequently experienced intrahepatic recurrence. Patients were assessed with conventional ultrasound and CEUS. They were also assessed with contrast-enhanced computed tomography (CECT) and/or magnetic resonance imaging (MRI). The image characteristics of CEUS of recurrent hepatocellular carcinoma and high-grade dysplastic nodules (HGDNs) were analyzed. In addition, the ability of CEUS and CECT/MRI to assess internal artery vascularization in recurrent disease was compared.

CEUS of recurrent hepatocellular carcinoma showed hyperenhancement in the arterial phase in 96 of 99 nodules, and it showed hypo- or isoenhancement for portal venous and delayed phases. The most common enhancement patterns were “fast-in and slow-out” and “fast-in and fast-out”. Based on the arterial hyperenhancement of lesions and with clinical data such as patient history of HCC and increased level of serum alpha-fetoprotein, the diagnostic accuracy of CEUS for recurrent HCC was significantly higher than that based on the enhancement pattern of “fast-in and fast-out”. CEUS of HGDNs showed local or global hyperenhancement during the arterial phase, isoenhancement during the portal venous phase, and isoenhancement or slight hypoenhancement during the delayed phase. The enhancement pattern was “fast-in and slow-out”. In some cases, it was difficult to differentiate HGDNs from recurrent disease using CEUS. Vascularization in recurrent disease was significantly higher when assessed by CEUS than when assessed with CECT/MRI (P < 0.05). For detecting recurrent disease, CEUS showed sensitivity of 97.0%, specificity of 68.0%, positive predictive value of 92.3%, and negative predictive value of 85.0%. The corresponding parameters for CECT/MRI were 71.7%, 72.0%, 88.8%, and 39.1%.

Intrahepatic recurrent HCC and HGDNs with diameter ≤ 3.0 cm have a characteristic appearance on CEUS. This imaging modality may be effective for monitoring early intrahepatic recurrence after curative treatment of primary HCC.

The aim of the present study was to evaluate the role of hepatectomy plus adjuvant transcatheter arterial chemoembolization (TACE) in patients with multicentric occurrence (MO) or intrahepatic metastases (IM) of hepatocellular carcinoma (HCC). Patients with multifocal HCC who underwent hepatic resection only (HR) or HR plus adjuvant TACE (HRT) between January 2005 and December 2015 were divided into MO or IM groups. The patient characteristics and outcomes were retrospectively analyzed. A total of 103 patients (59 and 44 in the MO and IM groups, respectively) were included in the analysis. The 1-, 3- and 5-year overall survival (OS) rates were 92.7, 76.8 and 56.8% for the MO group, and 93.1, 41.6 and 18.5% for the IM group, respectively (OS, P=0.001), and the 1-, 3- and 5-year disease-free survival (DFS) rates were 84.1, 44.6 and 40.5% for the MO group and 51.7, 22.5 and 15.0% for the IM group, respectively (DFS, P<0.001). In the subgroup analysis, the overall survival were significantly better in the MO-HRT group compared with those in the MO-HR group (P=0.019), which was also observed between the IM-HRT and IM-HR groups (P=0.132). Furthermore, the 1-, 3- and 5-year OS demonstrated non-significant differences between patients with <3 and ≥3 tumors in the MO-HR group (P=0.300), but significantly reduced OS for patients with ≥3 tumors in the IM-HR group compared with that for patients with <3 tumors (P=0.132). In conclusion, surgical resection combined with adjuvant TACE may result in significantly increased survival rates of patients with MO-HCC. Tumor number should not be an absolute contradiction to hepatectomy in patients with MO-HCC.

• hepatic resection
• hepatocellular carcinoma
• intrahepatic metastases
• multicentric occurrence
• survival
• transcatheter arterial chemoembolization

• Adult
• Aged
• Aged, 80 and over
• Carcinoma, Hepatocellular/surgery
• Female
• Follow-Up Studies
• Hepatectomy
• Humans
• Liver/surgery
• Liver Neoplasms/surgery
• Male
• Middle Aged
• Radiofrequency Ablation/methods
• Retrospective Studies
• Survival Rate
• Treatment Outcome

• Alpha-fetoprotein
• hepatitis B virus
• hepatitis B virus-related-acute-on-chronic liver failure
• liver disease
• overall survival
• risk factor

• Intrahepatic metastasis
• Intrahepatic recurrence
• Multicentric occurrence
• Radiofrequency ablation
• Re-resection
• Salvage liver transplantation

• hepatocellular carcinoma
• meta-analysis
• second-line treatment
• targeted agent

• Hepatectomy
• Intrahepatic cholangiocarcinoma
• Major
• Minor
• Outcomes

• Adult
• Aged
• Bile Duct Neoplasms/mortality
• Bile Duct Neoplasms/pathology
• Bile Duct Neoplasms/surgery
• Bile Ducts, Intrahepatic/surgery
• Cholangiocarcinoma/mortality
• Cholangiocarcinoma/pathology
• Cholangiocarcinoma/surgery
• Cohort Studies
• Female
• Hepatectomy
• Humans
• Male
• Middle Aged
• Survival Analysis
• Treatment Outcome

• Anatomic resection
• Hepatocellular carcinoma
• Non-anatomic resection
• Overall survival