Adjuvant Transcatheter Arterial Chemoembolization for Intrahepatic Cholangiocarcinoma after Curative Surgery: Retrospective Control Study

Shi, Weifeng; Zhong, Weixia; Liu, Q.; Sui, Chengjun; Huang, Yifeng; Yang, Jing

doi:10.1007/s00268-011-1171-y

Cited by 66 publications

(66 citation statements)

References 61 publications

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“…There is still no wellestablished adjuvant therapy for patients with ICC after liver resection [4]. Preliminary results from previously reported studies suggested that adjuvant TACE might benefit selected patients, but these studies failed to clarify how to select these patients [11][12][13]. In our study, we tried to identify this subgroup of patients through survival risk stratification.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies showed transarterial chemoembolization (TACE) to be beneficial for patients with advanced and unresectable ICCs [9,10]; however, to the best of our knowledge, only three studies reported the use of adjuvant TACE in ICC patients after curative resection. Shen et al reported that postoperative TACE failed to delay tumor recurrence but prolonged overall survival (OS) of patients with early tumor recurrence [11].Two other reports suggested that TACE improved survival of patients with ICC .5 cm or at an advanced TNM stage (stage III [T3N0M0] or IV [T4N0M0 and AnyTN1M0]) [12,13]. For patients with ICC at stage I (T1N0M0), this procedure not only failed to improve survival but might even promote tumor recurrence [13].These studies have been criticized because TACE was given to patients with varying degrees of predicted survival risk and because of relatively small sample sizes.…”

Section: Introductionmentioning

confidence: 99%

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Adjuvant Transarterial Chemoembolization Following Liver Resection for Intrahepatic Cholangiocarcinoma Based on Survival Risk Stratification

Wang

Lei

et al. 2015

The Oncologist

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Background. The effectiveness of adjuvant transarterial chemoembolization (TACE) for intrahepatic cholangiocarcinoma (ICC) after hepatectomy remains unclear. This study was performed to identify ICC patients who would benefit from adjuvant TACE. Patients and Methods. The study included 553 patients who underwent hepatectomy for ICC between January 2008 and February 2011 at the Eastern Hepatobiliary Surgery Hospital and who were treated with or without TACE (122 with TACE and 431 without TACE). Survival risk stratification was performed using the established prognostic nomogram (ICC nomogram). The predictive performance was evaluated by concordance index and calibration. The tumor recurrence and overall survival (OS) rates were analyzed by the Kaplan-Meier method before and after propensity score matching (PSM).

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Adjuvant Transarterial Chemoembolization Following Liver Resection for Intrahepatic Cholangiocarcinoma Based on Survival Risk Stratification

Wang

Lei

et al. 2015

The Oncologist

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“…Considerable interest has been paid to various treatment options against ICC recurrence such as surgical treatment,6, 7, 8 chemotherapy,9 radiation therapy,7 radiofrequency ablation (RFA),10, 11 and transarterial chemotherapy 12, 13 with various degrees of success. In recent reports, aggressive surgical treatment for ICC recurrence led to good patient survival after recurrence, with a 3‐year overall survival (OS) rate of 25%,14 40%,6 and 100% 7.…”

Section: Introductionmentioning

confidence: 99%

Surgical management of recurrent intrahepatic cholangiocarcinoma: predictors, adjuvant chemotherapy, and surgical therapy for recurrence: A multi‐institutional study by the Kyushu Study Group of Liver Surgery

Yamashita

Shirabe²,

Beppu³

et al. 2017

Annals of Gastroent Surgery

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Objectives of the present study were to identify predictors of the recurrence of intrahepatic cholangiocarcinoma (ICC), and to evaluate the survival benefit of adjuvant chemotherapy and surgical treatment for ICC recurrence. A multi‐institutional retrospective study was carried out in 356 patients with ICC who underwent curative surgery at one of 14 institutions belonging to the Kyushu Study Group of Liver Surgery. A total of 214 patients (60%) had recurrence. Predictors of ICC recurrence were as follows: positive for pathological intrahepatic metastasis (im), positive for lymph node metastasis (n), positive for pathological lymphatic infiltration (ly), pathological bile duct invasion (b), and tumor size ≥4.4 cm. Adjuvant chemotherapy was given to 120 patients (34%) and, in the patients with im or tumor size ≥4.4 cm, adjuvant chemotherapy showed a survival benefit. Only 37 patients (17%) underwent surgical treatment for ICC recurrence. The surgical treatment resulted in a good 5‐year survival rate (44%), which is similar to the rate obtained by the first operation for primary ICC. Prognosis of patients with primary im after the second operation was significantly worse (5‐year survival 18%) compared to patients without primary im. Primary im+ should be considered a contraindication for surgical treatment for ICC recurrence.

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“…The median OS in the adjuvant cTACE group was twelve months and surgery only resulted in a median OS of five months. However, cTACE did not delay the recurrence of the disease in this setting (14).…”

Section: A B Cmentioning

confidence: 64%

“…The most commonly used drug combination in the US and Europe consists of doxorubicin, cisplatin and mitomycin-C, but gemcitabine has also been used (13,14). The drug cocktail is brought into emulsion with Lipiodol, which has a dual function as a drug carrier as well as an embolic agent, that is able to penetrate the tumor vasculature up to the capillaries (12).…”

Section: Ctace-backgroundmentioning

confidence: 99%

Intra-arterial embolotherapy for intrahepatic cholangiocarcinoma: update and future prospects

Savic¹,

Chapiro²,

Geschwind³

2017

Hepatobiliary Surg. Nutr.

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Intrahepatic cholangiocarcinoma (ICC) is a rare disease and carries a poor prognosis with surgery remaining the only curative treatment option. However, due to the late presentation of symptoms and close proximity of the tumors to central hepatic structures, only about 30% of patients are classified eligible to resection. As for palliative approaches, ICC constitutes a possible indication for loco-regional therapies (LRT). As such, intra-arterial therapies (IAT) are reported to be feasible, safe and effective in inducing tumor response in unresectable ICC. The paradigm of IAT is premised on the selective delivery of embolic, chemotherapeutic agents to the tumor via its feeding arteries, thus allowing dose escalation within the carcinoma and reduction of systemic toxicity. Conventional transcatheter arterial chemoembolization (cTACE) so far remains the most commonly used IAT modality. However, drug-eluting beads (DEB)-TACE was initiated with the idea of more selective targeting of the tumor owing to the combined embolizing as well as drug-eluting properties of the microspheres used in this setting. Moreover, radioembolization is performed by intra-arterial administration of very small spheres containing β-emitting yttrium-90 (Y90-RE) to the site of the tumor. Clinical evidence exists in support of survival benefits for IAT in the palliative treatment of ICC compared to surgery and systemic chemotherapy. As for combination regimens, cTACE, DEB-TACE and Y90-RE are reported to achieve conversion of patients to surgery in a sequential treatment planning and simultaneous IAT combinations may provide a therapeutic option for treatment escalation. Regarding the current status of literature, controlled randomized prospective trials to compare different IAT techniques and combination therapies as well as treatment recommendations for different IAT modalities are needed.

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Adjuvant Transcatheter Arterial Chemoembolization for Intrahepatic Cholangiocarcinoma after Curative Surgery: Retrospective Control Study

Abstract: Adjuvant TACE after radical surgery was associated with better survival among the ICC patients with early recurrence.

Cited by 66 publications

References 61 publications

Adjuvant Transarterial Chemoembolization Following Liver Resection for Intrahepatic Cholangiocarcinoma Based on Survival Risk Stratification

Adjuvant Transarterial Chemoembolization Following Liver Resection for Intrahepatic Cholangiocarcinoma Based on Survival Risk Stratification

Surgical management of recurrent intrahepatic cholangiocarcinoma: predictors, adjuvant chemotherapy, and surgical therapy for recurrence: A multi‐institutional study by the Kyushu Study Group of Liver Surgery

Intra-arterial embolotherapy for intrahepatic cholangiocarcinoma: update and future prospects

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