LAUSR

Intrahepatic cholangiocarcinoma (ICC) is an aggressive liver malignancy associated with poor outcomes. Traditional risk factors for adverse outcomes include tumor size and number, microand macrovascular invasion, and presence of lymph node metastases, which have been included in the current American Joint Committee on Cancer (AJCC) staging system. Although tumor necrosis on pathology has been associated with poor outcomes among individuals with other solid tumors, the impact of tumor necrosis on outcomes of patients with ICC remains ill-defined. In the current study, we sought to define the prognostic impact of tumor necrosis among patients who underwent resection of ICC utilizing a large multi-institutional database. In addition, we examined whether a modified T classification that incorporates tumor necrosis in the existing AJCC staging schema could better stratify outcomes among individuals undergoing resection for ICC.