Association of Liver-Directed Local Therapy With Overall Survival in Adults With Metastatic Intrahepatic Cholangiocarcinoma

Sebastian, Nikhil; Tan, Yubo; Miller, Eric D.; Williams, Terence M.; Noonan, Anne M.; Hays, John L.; Abdel‐Misih, Sherif; Diaz, Dayssy Alexandra

doi:10.1001/jamanetworkopen.2019.11154

Cited by 11 publications

(11 citation statements)

References 33 publications

(56 reference statements)

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“…Most of the morbidity and mortality among patients with metastatic ICC is due to liver disease and liver failure. Therefore, the selective use of liver-directed therapies, even in the presence of metastatic disease, may improve local disease control, health related quality of life, and potentially overall survival[ 35 ].…”

Section: Management Of Iccmentioning

confidence: 99%

Neoadjuvant treatment strategies for intrahepatic cholangiocarcinoma

Akateh¹,

Ejaz²,

Pawlik³

et al. 2020

WJH

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Intrahepatic cholangiocarcinoma (ICC) is the second most common primary liver malignancy and is increasing in incidence. Long-term outcomes are optimized when patients undergo margin-negative resection followed by adjuvant chemotherapy. Unfortunately, a significant proportion of patients present with locally advanced, unresectable disease. Furthermore, recurrence rates are high even among patients who undergo surgical resection. The delivery of systemic and/or liver-directed therapies prior to surgery may increase the proportion of patients who are eligible for surgery and reduce recurrence rates by prioritizing early systemic therapy for this aggressive cancer. Nevertheless, the available evidence for neoadjuvant therapy in ICC is currently limited yet recent advances in liver directed therapies, chemotherapy regimens, and targeted therapies have generated increasing interest its role. In this article, we review the rationale for, current evidence for, and ongoing research efforts in the use of neoadjuvant therapy for ICC.

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Section: Management Of Iccmentioning

confidence: 99%

Neoadjuvant treatment strategies for intrahepatic cholangiocarcinoma

Akateh¹,

Ejaz²,

Pawlik³

et al. 2020

WJH

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“…In the setting of metastatic intrahepatic cholangiocarcinoma, a cohort study used the National Cancer Database showed that liverdirected local therapy was associated with improved survival. 24 Hu et al 22 evaluated prognostic factors, treatments, and survival outcomes of 81 patients with HCCPM. They found that liver resection might be associated with better survival when compared with ablation or transarterial chemoembolization in selected patients.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary metastases in newly diagnosed hepatocellular carcinoma: a population-based retrospective study

Feng

Wan

et al. 2020

HPB

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Background: Hepatocellular carcinoma (HCC) is a major form of primary liver cancer with steadily increasing incidence for the decades, and has propensity to have extrahepatic metastases, especially pulmonary metastases (PM). This study aimed to investigate temporal incidence trends, treatment, and survival of patients with HCCPM.Methods: Patients with HCCPM were retrospectively reviewed from 2010 to 2016 in US National Cancer Institute (NCI) Surveillance, Epidemiology, and End Results registry (SEER).Results: 2242 patients with HCCPM were identified. Overall HCCPM incidence did not change from 2010 to 2016, with an annual percent change (APC) of 0.87% (95% CI = −2.50%-4.35%, P = 0.542).Similar incidence trends patterns were found in subgroup analyses of sex, age, and race. 1-year observed survival for HCCPM was 10.8% (95%CI = 8.9%-12.8%) and relative survival was 11.0% (95%CI = 9.1%-13.1%). Better outcomes were noted among patients who underwent liver-directed surgery, those who treated with chemotherapy, and those who received radiation. Conclusions:The incidence of HCCPM does not increase with the increasing incidence of HCC. Patients with HCCPM have a dismal prognosis with low survival rates. Liver-directed surgery, use of chemotherapy, and radiation may be associated with improved outcomes.

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“…The CCA median survival is about 12 months. The prognosis is unfavorable in CCA because of the lack of response to chemotherapy and radiotherapy [ 14 , 15 ]. The only option that remains is palliative care, symptomatic therapy – pain management – in order to improve the patients’ quality of life.…”

Section: Discussionmentioning

confidence: 99%