Predictors of Cure of Intrahepatic Cholangiocarcinoma After Hepatic Resection

Tsukamoto, M; Yamashita, Yo Ichi; Imai, Katsunori; Umezaki, Naoki; Yamao, Takanobu; Okabe, Hidetoshi; Nakagawa, Shigeki; Hashimoto, Daisuke; Chikamoto, Akira; Ishiko, Takatoshi; Yoshizumi, Tomoharu; Maehara, Yoshihiko; Baba, Hideo

doi:10.21873/anticanres.12164

Cited by 14 publications

(13 citation statements)

References 20 publications

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“…Several studies have reported increasing incidence of ICC in the last decades ( 5 , 6 ) and the 5-year survival rate is still lower than 10% ( 7 ). At present, hepatectomy is still the most effective treatment for long-term survival of ICC patients ( 8 , 9 ), and several poor prognostic factors have been reported, including lymph node metastasis, microvascular invasion (MVI), tumor size ≥5 cm, and multiple nodules ( 10 ).…”

Section: Introductionmentioning

confidence: 99%

“…However, the status of MVI is difficult to detect by radiographic images and can only be determined by histological evaluation after hepatectomy ( 14 ). In addition, MVI can affect the selection of personalized therapeutic regime, for instance, ICC patients without MVI do not need to receive adjuvant chemotherapy after R0 resections ( 10 ). Herein, the preoperative determination of MVI status is of great value in ICC patients, and it holds promises for effective patient management and estimation of outcomes.…”

Section: Introductionmentioning

confidence: 99%

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A Multi-Parametric Radiomics Nomogram for Preoperative Prediction of Microvascular Invasion Status in Intrahepatic Cholangiocarcinoma

Qian

Lü

et al. 2022

Front. Oncol.

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BackgroundIntrahepatic cholangiocarcinoma (ICC) is the second most common primary liver cancer with increasing incidence in the last decades. Microvascular invasion (MVI) is a poor prognostic factor for patients with ICC, which correlates early recurrence and poor prognosis, and it can affect the selection of personalized therapeutic regime.PurposeThis study aimed to develop and validate a radiomics-based nomogram for predicting MVI in ICC patients preoperatively.MethodsA total of 163 pathologically confirmed ICC patients (training cohort: n = 130; validation cohort: n = 33) with postoperative Ga-DTPA-enhanced MR examination were enrolled, and a time-independent test cohort (n = 24) was collected for external validation. Univariate and multivariate analyses were used to determine the independent predictors of MVI status, which were then incorporated into the MVI prediction nomogram. Least absolute shrinkage and selection operator logistic regression was performed to select optimal features and construct radiomics models. The prediction performances of models were assessed by receiver operating characteristic (ROC) curve analysis. The performance of the MVI prediction nomogram was evaluated by its calibration, discrimination, and clinical utility.ResultsLarger tumor size (p = 0.003) and intrahepatic duct dilatation (p = 0.002) are independent predictors of MVI. The final radiomics model shows desirable and stable prediction performance in the training cohort (AUC = 0.950), validation cohort (AUC = 0.883), and test cohort (AUC = 0.812). The MVI prediction nomogram incorporates tumor size, intrahepatic duct dilatation, and the final radiomics model and achieves excellent predictive efficacy in training cohort (AUC = 0.953), validation cohort (AUC = 0.861), and test cohort (AUC = 0.819), fitting well in calibration curves (p > 0.05). Decision curve and clinical impact curve further confirm the clinical usefulness of the nomogram.ConclusionThe nomogram incorporating tumor size, intrahepatic duct dilatation, and the final radiomics model is a potential biomarker for preoperative prediction of the MVI status in ICC patients.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Multi-Parametric Radiomics Nomogram for Preoperative Prediction of Microvascular Invasion Status in Intrahepatic Cholangiocarcinoma

Qian

Lü

et al. 2022

Front. Oncol.

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“…Radical surgical resection is an acceptable form of curative treatment. However, there are no noticeable symptoms in the early stage of cholangiocarcinoma [1]; thus, patients are usually diagnosed in the advanced or metastatic stages of the disease, making it difficult to perform 2 of 17 surgical resection [2][3][4]. In the past decade, the incidence of cholangiocarcinoma has rapidly increased globally [5], necessitating the development of strategies for early diagnosis and effective treatment.…”

Section: Introductionmentioning

confidence: 99%

TESC Promotes TGF-α/EGFR-FOXM1-Mediated Tumor Progression in Cholangiocarcinoma

Hsieh

Chu

Lin

et al. 2020

Cancers

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Cholangiocarcinoma is a relatively uncommon but highly lethal malignancy. Improving outcomes in patients depends on earlier diagnosis and appropriate treatment; however, no satisfactory diagnostic biomarkers or targeted therapies are currently available. To address this shortcoming, we analyzed the transcriptomic datasets of cholangiocarcinoma from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases and found that TESC is highly expressed in cholangiocarcinoma. Elevated cellular levels of TESC are correlated with larger tumor size and predict a poor survival outcome for patients. Knockdown of TESC via RNA interference suppresses tumor growth. RNA-sequencing analysis showed that silencing of TESC decreases the level of FOXM1, leading to cell cycle arrest. Correlation analysis revealed that the cellular level of TESC is correlated with that of FOXM1 in cholangiocarcinoma patients. We further observed that upon TGF-α induction, TESC is upregulated through the EGFR-STAT3 pathway and mediates TGF-α-induced tumor cell proliferation. In vivo experiments revealed that knockdown of TESC significantly attenuates tumor cell growth. Therefore, our data provide novel insight into TESC-mediated oncogenesis and reveal that TESC is a potential biomarker or serves as a therapeutic target for cholangiocarcinoma.

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“…In addition, due to its insidious onset and high malignancy, it is often found in advanced stages at diagnosis [10]. Therefore, the surgical resection rate of cholangiocarcinoma is low [11, 12]. It is of increasing clinical importance to evaluate the resectability of the tumor before operation.…”

Section: Introductionmentioning

confidence: 99%

Clinical Significance of Preoperative Serum CEA, CA125, and CA19-9 Levels in Predicting the Resectability of Cholangiocarcinoma

Fang

Wang

et al. 2019

Disease Markers

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To explore the clinical significance of preoperative serum CEA, CA125, and CA19-9 levels in predicting the resectability of cholangiocarcinoma. Patients with cholangiocarcinoma diagnosed by radiologic examination and admitted to the Second Affiliated Hospital of Harbin Medical University from September 1, 2011, to November 30, 2017, were retrospectively included. The relationship between the preoperative serum CEA, CA125, and CA19-9 levels and the resectability of cholangiocarcinoma was analyzed by receiver operating characteristic (ROC) curve, as well as the best cut-off point. A total of 112 met the inclusion criteria. In 50 patients with radical surgeries, the levels of preoperative serums CEA, CA125, and CA19-9 were 5.0 ± 13.9 ng/mL, 15.3 ± 11.8 U/mL, and 257.5 ± 325.6 U/mL, respectively, which were lower than those in patients with unresectable tumor. Based on the ROC curve, the ideal CA19-9 cut-off value was determined to be 1064.1 U/mL in prediction of resectability, with a sensitivity of 53.2%, a specificity of 94.0%, and the area under the ROC curve of 0.73 (P<0.05). The cut-off value of CA125 was 17.8 U/mL with a sensitivity of 72.6%, a specificity of 78.0%, and the area under the ROC curve of 0.81 (P<0.05). The cut-off value of CEA was 2.6 ng/mL with a sensitivity of 79.0%, a specificity of 48.0%, and the area under the ROC curve of 0.66 (P<0.05). In addition to this, we found that using the combination of three tumor markers could improve the value in predicting resectability of cholangiocarcinoma. In summary, this study suggested that the preoperative serum CEA, CA125, and CA19-9 levels can help predict the resectability of cholangiocarcinoma.

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Predictors of Cure of Intrahepatic Cholangiocarcinoma After Hepatic Resection

Abstract: R0 resections achieved a cure in 45.7% of this series of ICC patients. The predictors of a cure identified here, i.e., absence of lymph node metastasis and absence of microvascular invasion, could contribute to the selection of patients who are not candidates for adjuvant chemotherapy.

Cited by 14 publications

References 20 publications

A Multi-Parametric Radiomics Nomogram for Preoperative Prediction of Microvascular Invasion Status in Intrahepatic Cholangiocarcinoma

A Multi-Parametric Radiomics Nomogram for Preoperative Prediction of Microvascular Invasion Status in Intrahepatic Cholangiocarcinoma

TESC Promotes TGF-α/EGFR-FOXM1-Mediated Tumor Progression in Cholangiocarcinoma

Clinical Significance of Preoperative Serum CEA, CA125, and CA19-9 Levels in Predicting the Resectability of Cholangiocarcinoma

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