Transarterial Chemoembolization: A Favorable Postoperative Management to Improve Prognosis of Hepatitis B Virus-associated Intrahepatic Cholangiocarcinoma after Surgical Resection

Abstract

Background: There is no information regarding transarterial chemoembolization (TACE) as a postoperative management after hepatic resection for patients with hepatitis B virus (HBV)-associated intrahepatic cholangiocarcinoma (ICC).Methods: Forty-two patients with pathological confirmation of HBV-associated ICC were enrolled. Prognostic impact of the clinicopathological factors as well as postoperative TACE were evaluated. Computed tomography findings of HBV-associated ICC were assessed.Results: Tumor size of larger than 5 cm (hazard ratio [HR], 5.654; 95% confidence interval [CI], 1.175 to 27.204; P = 0.031), postoperative TACE (HR, 0.123; 95% CI, 0.023 to 0.643; P = 0.013), and lymph node metastasis (HR, 3.284; 95% CI, 1.236 to 8.724; P = 0.017) revealed to be independently associated with survival outcomes of patients with HBV-associated ICC. Application of TACE, as a postoperative management to control early local recurrence on the basis of hepatic arterial phase enhancement, significantly prolonged survival outcomes (1-yr, 88.9%; 3-yr, 77.8%; 5-yr, 66.7%), compared to the patients who did not receive TACE (1-yr, 63.6%; 3-yr, 30.8%; 5-yr, 13.0%). When analyzed according to the status of hepatic arterial phase, arterial phase enhancement demonstrated a favorable trend on prognosis of patients with HBV-associated ICC without statistical significance (HR, 0.435; 95% CI, 0.140 to 1.359; P = 0.141), and TACE independently improved overall survival of patients with arterial phase enhancement (HR, 0.105; 95% CI, 0.014 to 0.774; P = 0.027).Conclusions: Put together, our results indicate that postoperative TACE effectively improves prognosis of HBV-associated ICC with arterial phase enhancement in CT scans. Large-sized trials are required for our results to be applied in clinical medicine.

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

“…TACE is often used to manage ICC in unresectable patients, but more recently, adjuvant TACE has also been administered to reduce ICC recurrence . Previous studies have found that adjuvant TACE can improve ICC patient prognosis following resection, mainly by reducing the rate of recurrence.…”

“…Recently, AT, such as transarterial chemoembolization (TACE), chemotherapy, radiotherapy, and comprehensive treatment, has been conducted prevalently worldwide to improve ICC patient prognosis after radical resection . However, there is still controversy over whether ICC patients can benefit from AT after radical resection .…”

Reply

“…This approach also extends to their reported good outcome of HBV-associated ICC treated with resection and postoperative chemoembolization. (2) Although this study shows interesting results, it exceeds the scope of our review and as previously discussed, prospective clinical trials comparing this to a more definitive treatment option such as LT would better assess the best approach for this patient population.…”

Effects of propofol on human cholangiocarcinoma and the associated mechanisms�

“…CCA is a rapidly growing and lethal cancer that is usually incurable unless the primary tumor and any metastases are removed completely by surgery (22). As surgical treatment is prone to complications and seriously affects the quality of life of patients, in the postoperative period, it is necessary to strengthen the rehabilitation of patients with CCA from psychological and dietary perspectives (23,24). Following CCA surgery, patients should follow their doctor's advice and (25).…”