Guidelines Insights: Hepatobiliary Cancers, Version 2.2019

Benson, Al B.; D’Angelica, Michael I.; Abbott, Daniel E.; Abrams, Thomas A.; Alberts, Steven R.; Anaya, Daniel A.; Anders, Robert A.; Are, Chandrakanth; Brown, Daniel B.; Chang, Daniel T.; Cloyd, Jordan M.; Covey, Anne M.; Hawkins, William G.; Iyer, Renuka; Jacob, Rojymon; Karachristos, Andreas; Kelley, Robin Kate; Kim, Robin; Palta, Manisha; Park, James O.; Sahai, Vaibhav; Schefter, Tracey E.; Sicklick, Jason K.; Singh, Gagandeep; Sohal, Davendra; Stein, Stacey; Tian, Guo; Vauthey, Jean Nicolas; Venook, Alan P.; Hammond, Lydia J.; Darlow, Susan

doi:10.6004/jnccn.2019.0019

Cited by 234 publications

(199 citation statements)

References 46 publications

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“…Patients included in the study were divided into three subgroups according to the 8th AJCC staging system . In total, 242 (58.74%), 114 (27.67%), and 56 (13.59%) patients were in the stage Ⅰ, stage Ⅱ, and stage Ⅲ subgroups, respectively.…”

Section: Resultsmentioning

confidence: 99%

“…The AJCC cancer staging system is the most widely used staging system to predict the prognosis of ICC worldwide. In this study, patients were divided into three groups according to the 8th AJCC cancer staging system for ICC, each with distinct OS differences ( P < .05). However, this failed to confirm the benefit of AT in any of the subgroups.…”

Section: Discussionmentioning

confidence: 99%

“…Patients from the AT and non‐AT groups were then subdivided into groups according to the 8th American Joint Committee on Cancer (AJCC) staging system and the established nomogram . The median OS for each AT and non‐AT subgroups was then calculated using the Kaplan‐Meier method.…”

Section: Methodsmentioning

confidence: 99%

“…The incidence of ICC is increasing worldwide, with an average 2.3% annual increase . The 5‐year survival rate for patients with ICC is less than 10%, partly because approximately 80% of patients are diagnosed at a late stage when surgery is no longer a treatment option . Currently, radical resection is the only potentially curative strategy for patients with ICC, but the 5‐year survival rate even after radical resection is far from satisfactory.…”

Section: Introductionmentioning

confidence: 99%

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Postoperative adjuvant therapy following radical resection for intrahepatic cholangiocarcinoma: A multicenter retrospective study

et al. 2020

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Background and Aims: The prognosis of intrahepatic cholangiocarcinoma (ICC) after radical resection is far from satisfactory; however, the clinical value of adjuvant therapy (AT) remains controversial. This multicenter study aimed to evaluate the clinical value of AT and identify potential patients who would be benefited from AT. Methods: Data from ICC patients who underwent radical resection were retrospectively collected from 12 hepatobiliary centers in China between December 2012 and December 2015. Patients were divided into AT and non-AT groups based on whether AT was administered or not. Overall survival (OS) and disease-free survival (DFS)were analyzed using the Kaplan-Meier method before and after 1:2 propensity score matching (PSM). Subgroup analyses were conducted based on the established staging systems. | 2675WANG et Al.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Postoperative adjuvant therapy following radical resection for intrahepatic cholangiocarcinoma: A multicenter retrospective study

et al. 2020

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“…According to clinical guidelines, 16 all patients with HCC who had received curative resection were recommended to receive regular follow‐up. In this study, within the first year after surgery, all patients were followed up every 3 months at the outpatient department by the surgeon, and at least every 6 months thereafter.…”

Section: Methodsmentioning

confidence: 99%

Prognostic role of tumor mutation burden in hepatocellular carcinoma after radical hepatectomy

Cai

Zhang

Cui

et al. 2020

Journal of Surgical Oncology

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Background and Aim This study aimed to assess the potential relationship between tumor mutation burden (TMB) and the recurrence risk of hepatocellular cancer (HCC) after curative resection and tried to develop a reliable TMB based nomogram. Methods This retrospective study was conducted in 128 patients (40 patients suffered from a recurrence of HCC) who had received radical hepatectomy by the same surgical team. A nomogram model was constructed using the R and EmpowerStats software. Results TMB was not associated with maximum tumor size and the presence of microvascular invasion (MVI). In the whole population or subgroups, the recurrence‐free survival (RFS) rate was significantly lower in the TMB high group. In multivariate analysis, TMB (hazard ratio [HR], 10.12; 95% confidence interval [CI], 5.03‐20.31; P < .001), large tumor diameter (HR, 2.91; 95% CI, 1.51‐5.63; P = .001), presence of MVI (HR, 1.93; 95% CI, 1.03‐3.65; P = .042) were independent predictors of RFS. The predictive power of the nomogram integrating TMB, tumor size and MVI was higher than model only incorporating tumor size and MVI. Conclusion This study demonstrated for the first time that higher TMB was associated with poor prognosis in patients with HCC who had received curative resection, and a TMB based nomogram model had a well predictive performance for RFS in this population.

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Uptake and Survival Outcomes Following Immune Checkpoint Inhibitor Therapy Among Trial-Ineligible Patients With Advanced Solid Cancers

et al. 2021

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Immune checkpoint inhibitors (ICIs) are part of standard of care for patients with many advanced solid tumors. Patients with poor performance status or organ dysfunction are traditionally ineligible to partake in pivotal randomized clinical trials of ICIs.OBJECTIVE To assess ICI use and survival outcomes among patients with advanced cancers who are traditionally trial ineligible based on poor performance status or organ dysfunction. DESIGN, SETTING, AND PARTICIPANTSThis retrospective cohort study was conducted in 280 predominantly community oncology practices in the US and included 34 131 patients (9318 [27.3%] trial ineligible) who initiated first-line systemic therapy from January 2014 through December 2019 for newly diagnosed metastatic or recurrent nontargetable non-small cell lung, urothelial cell, renal cell, or hepatocellular carcinoma. Data analysis was performed from December 1, 2019, to June 1, 2021.EXPOSURES Trial ineligibility (Eastern Cooperative Oncology Group performance status Ն2 or the presence of kidney or liver dysfunction); first-line systemic therapy. MAIN OUTCOMES AND MEASURESThe association between trial ineligibility and ICI monotherapy uptake was assessed using inverse probability-weighted (IPW) logistic regressions. The comparative survival outcomes following ICI and non-ICI therapy among trial-ineligible patients were assessed using treatment IPW survival analyses. Because we observed nonproportional hazards, we reported 12-month and 36-month restricted mean survival times (RMSTs) and time-varying hazard ratios (HRs) of less than 6 months and 6 months or greater. RESULTS Among the overall cohort (n = 34 131), the median (IQR) age was 70 (62-77) years; 23 586 (69%) were White individuals, and 14 478 (42%) were women. Over the study period, the proportion of patients receiving ICI monotherapy increased from 0% to 30.2% among trial-ineligible patients and 0.1% to 19.4% among trial-eligible patients. Trial ineligibility was associated with increased ICI monotherapy use (IPW-adjusted odds ratio compared with non-ICI therapy, 1.8; 95% CI, 1.7-1.9). Among trial-ineligible patients, there were no overall survival differences between ICI monotherapy, ICI combination therapy, and non-ICI therapy at 12 months (RMST, 7.8 vs 7.7 vs 8.1 months) or 36 months (RMST, 15.0 vs 13.9 vs 14.4 months). Compared with non-ICI therapy, ICI monotherapy showed evidence of early harm (IPW-adjusted HR within 6 months, 1.2; 95% CI, 1.1-1.2) but late benefit (adjusted HR among patients who survived 6 months, 0.8; 95% CI, 0.7-0.8). CONCLUSIONS AND RELEVANCEIn this cohort study, compared with trial-eligible patients, trial-ineligible patients with advanced cancers preferentially received first-line ICI therapy. A survival difference was not detected between ICI and non-ICI therapies among trial-ineligible patients. Positive results for ICI in phase 3 trials may not translate to this vulnerable population.

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Guidelines Insights: Hepatobiliary Cancers, Version 2.2019

Cited by 234 publications

References 46 publications

Postoperative adjuvant therapy following radical resection for intrahepatic cholangiocarcinoma: A multicenter retrospective study

Postoperative adjuvant therapy following radical resection for intrahepatic cholangiocarcinoma: A multicenter retrospective study

Prognostic role of tumor mutation burden in hepatocellular carcinoma after radical hepatectomy

Uptake and Survival Outcomes Following Immune Checkpoint Inhibitor Therapy Among Trial-Ineligible Patients With Advanced Solid Cancers

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