Adjuvant transarterial chemoembolization following radical resection for intrahepatic cholangiocarcinoma: A multi-center retrospective study

Wang, Lei; Lin, Zi Guo; Lou, Jian; Zheng, Shu Guo; Bi, Xin; Wang, Jian Ming; Guo, Wei; Li, Fu Yu; Wang, Jian; Zheng, Ya Min; Li, Jing Dong; Cheng, Sheue-yann; Zhou, Wei; Zeng, Yong

doi:10.7150/jca.40358

Cited by 14 publications

(12 citation statements)

References 31 publications

(56 reference statements)

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“…Systemic chemotherapy combined with local therapy can significantly improve patient prognosis. Intra-arterial therapies combined with chemotherapy can shrink the lesion to achieve R0 resection[ 34 ]. In this study, the median survival of 3 patients with recurrent ICC treated with TACE combined with the GEMOX regimen was 5 mo, which was longer than that of patients with recurrent ICC using chemotherapy alone (median OS, 4 mo).…”

Section: Discussionmentioning

confidence: 99%

Prognostic factors of recurrent intrahepatic cholangiocarcinoma after hepatectomy: A retrospective study

Yuan¹,

Fang²,

Feng³

et al. 2022

WJG

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BACKGROUND Intrahepatic cholangiocarcinoma (ICC) is a highly malignant tumour. Hepatectomy is an effective treatment for early ICC, but postoperative recurrence greatly affects patient survival. Studies on recurrent ICC after hepatectomy are lacking. AIM To investigate the clinical characteristics of patients with recurrent ICC after hepatectomy, analyse prognostic factors and explore diagnosis and treatment strategies. METHODS A retrospective analysis was performed on all ICC patients undergoing hepatectomy from January 2013 to August 2021. Patients with postoperative recurrence were selected according to the inclusion and exclusion criteria. Cumulative overall survival was plotted by the Kaplan-Meier method, and differences were assessed by univariate survival analysis using the log-rank test. Multivariate analysis of cumulative survival was performed using the Cox proportional risk model. RESULTS During the 8-year study period, 103 patients underwent ICC-related hepatectomy, and 54 exhibited postoperative recurrence. The median disease-free survival (DFS) was 6 mo, the median overall survival (OS) was 9 mo, and the cumulative OS rates at 1, 2 and 3 years after the operation were 40.7%, 14.8% and 7.4%, respectively. The median OS after recurrence was 4 mo, and the cumulative OS rates at 1, 2 and 3 years after recurrence were 16.1%, 6.7% and 3.4%, respectively. Multivariate analysis showed that alcohol consumption [hazard ratio (HR) = 4.64, 95% confidence interval (CI): 1.53-14.04, P = 0.007] and DFS < 6 mo (HR = 3.47, 95%CI: 1.59-7.60, P = 0.002) were independent risk factors for the cumulative survival of patients with recurrence, while treatment after recurrence (HR = 0.21, 95%CI: 0.08-0.55, P = 0.001) was an independent protective factor. The median OS time of patients receiving multimodality therapy after recurrence of ICC was 7 mo, which was significantly higher than that of patients receiving only local therapy (3 mo), patients receiving systematic therapy (4 mo) and patients receiving the best supportive therapy (1 mo). Patients with recurrent ICC who received multimodality therapy had a significantly better long-term survival after recurrence than those who did not ( P = 0.026). CONCLUSION The prognosis of patients with recurrence after ICC-related hepatectomy is poor. Alcohol consumption and DFS < 6 mo are independent risk factors in terms of the cumulative survival of patients with recurrence, while treatment after recurrence is an independent protective factor. Multimodality therapy can effectively improve the prognosis of patients.

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Section: Discussionmentioning

confidence: 99%

Prognostic factors of recurrent intrahepatic cholangiocarcinoma after hepatectomy: A retrospective study

Yuan¹,

Fang²,

Feng³

et al. 2022

WJG

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“…Based on the literature search strategy, 1,684 records of study were identified. After duplicate removal, title and abstract review, and full-text reading, a total of eleven studies [23][24][25][26][27][28][29][30][31][32][33] with 2,757 patients were finally included in the study. A flow diagram of the study search and selection process is shown in Fig.…”

Section: Study Selection and Clinical Characteristicsmentioning

confidence: 99%

“…Almost all included studies were published in English and only one study was published in Chinese [23]. Six studies [24,26,[28][29][30]33] considered the effect of MVI on ICC, and one of the studies [33] only performed postoperative adjuvant TACE after hepatectomy in ICC patients with MVI. Ten studies [23-30, 32,33] and seven studies [23,24,26,29,30,32,33] reported LNM and multifocal ICC tumor, respectively.…”

Section: Study Selection and Clinical Characteristicsmentioning

confidence: 99%

“…Six studies [24,26,[28][29][30]33] considered the effect of MVI on ICC, and one of the studies [33] only performed postoperative adjuvant TACE after hepatectomy in ICC patients with MVI. Ten studies [23-30, 32,33] and seven studies [23,24,26,29,30,32,33] reported LNM and multifocal ICC tumor, respectively. Nine studies [24][25][26][27][29][30][31][32][33] considered the TNM stage of ICC and two studies [26,31] included cases of mostly stage I disease.…”

Section: Study Selection and Clinical Characteristicsmentioning

confidence: 99%

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Adjuvant Transarterial Chemoembolization for Patients with Intrahepatic Cholangiocarcinoma after Surgical Resection: A Systematic Review and Meta-analysis

Wang

Wen

Zhuang³

et al. 2022

JGLD

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Aim: To investigate the efficacy of postoperative adjuvant transarterial chemoembolization (TACE) in patients with intrahepatic cholangiocarcinoma (ICC) after resection. Methods: Studies were systematically searched until August 2021 in the following databases: MEDLINE, EMBASE, PUBMED, Web of Science, Cochrane Library, Science Direct, and Springer Link. Overall survival (OS) and recurrence-free survival (RFS) were considered as the main outcomes. Pooled hazard ratio (HR) with 95% confidence interval (95%CI) was reported as results for the survival data. Subgroup analysis was conducted on the outcomes stratified by early-stage ICC and intra-arterial chemotherapeutic regimen. Results: Eleven studies with 2,757 patients were finally included in the study. The pooled HR of OS was 0.68 (95%CI: 0.50-0.87, I 2 =83.7%). The pooled HR of RFS was 1.00 (95%CI: 0.69-1.31, I 2 =88%). Receipt of postoperative adjuvant TACE improved the OS in the early-stage ICC subgroup (HR=0.68, 95%CI: 0.50-0.86, I 2 =54%). Addition of carboplatin could slightly improve the OS (HR=0.6, 95%CI: 0.35-0.85, I 2 =48%). But receipt of postoperative adjuvant TACE (HR=1.06, 95%CI: 0.83-1.29, I 2 =41.2%) or use of carboplatin (HR=1.30, 95%CI: 0.93-1.67, I 2 =0%) caused no significant improvement in the RFS in the early-stage ICC subgroup. Conclusions: Postoperative adjuvant TACE could improve the OS in ICC patients after hepatectomy but could not prevent late recurrence. Survival benefit was also found in early-stage ICC patients undergoing postoperative adjuvant TACE after hepatectomy. Addition or non-addition of carboplatin in chemoembolization showed a similar OS outcome.

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“…Another multicentric retrospective study between 2014 and 2017 analyzed 335 patients in 12 centers ( 50 ). The median OS of patients in the TACE plus surgery group was longer than that of patients in the surgery group (63 vs 18 months, P = 0.041).…”

Section: Interventional Treatment For Ccamentioning

confidence: 99%

Interventional Treatment for Cholangiocarcinoma

Chen

Zhu

et al. 2021

Front. Oncol.

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Cholangiocarcinoma (CCA) is the second most common type of primary liver malignancy. The latest classification includes intrahepatic cholangiocarcinoma and extrahepatic cholangiocarcinoma, with the latter one further categorized into perihilar and distal cholangiocarcinoma. Although surgical resection is the preferred treatment for CCA, less than half of the patients are actually eligible for radical surgical resection. Interventional treatment, such as intra-arterial therapies, ablation, and brachytherapy (iodine-125 seed implantation), has become an acceptable palliative treatment for patients with unresectable CCA. For these patients, interventional treatment is helpful for locoregional control, symptom relief, and improving quality of life. Herein, in a timely and topical manner, we will review these advances and highlight future directions of research in this article.

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Adjuvant transarterial chemoembolization following radical resection for intrahepatic cholangiocarcinoma: A multi-center retrospective study

Cited by 14 publications

References 31 publications

Prognostic factors of recurrent intrahepatic cholangiocarcinoma after hepatectomy: A retrospective study

Prognostic factors of recurrent intrahepatic cholangiocarcinoma after hepatectomy: A retrospective study

Adjuvant Transarterial Chemoembolization for Patients with Intrahepatic Cholangiocarcinoma after Surgical Resection: A Systematic Review and Meta-analysis

Interventional Treatment for Cholangiocarcinoma

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