Effect of Tumor Size on Long-Term Survival After Resection for Solitary Intrahepatic Cholangiocarcinoma

Kong, Junjie; Cao, Yongji; Chai, Jiawei; Liu, Xihan; Wang, Jianping; Li, Jun

doi:10.3389/fonc.2020.559911

Cited by 8 publications

(7 citation statements)

References 32 publications

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“…Despite accumulating evidence supporting a therapeutic benefit of routine LND in hepatic resection for ICC, other studies have demonstrated that LND did not influence the prognosis of patients with ICC who underwent surgery 24–26 . In addition, several previous studies have also demonstrated that tumor size is an important prognostic factor for ICC 27,28 . The multivariable Cox regression analysis of our study showed that surgery, AJCC TNM stage, and race of white were independent risk factors associated with OS of ICC instead of LND or tumor size.…”

Section: Discussioncontrasting

confidence: 82%

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Impact of cirrhosis on long‐term survival outcomes of patients with intrahepatic cholangiocarcinoma

et al. 2022

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Background:The correlation between cirrhosis and the long-term oncological outcome in intrahepatic cholangiocarcinoma (ICC) is debatable, and this study aimed to explore the impact of cirrhosis on the long-term prognosis of patients with ICC. Methods: A total of 398 ICC patients were identified in the Surveillance, Epidemiology, and End Results (SEER) database from 2000 to 2018. The diagnosis of cirrhosis was based on the Ishak fibrosis score provided by the SEER database. Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) analysis were performed to minimize the potential confounders. Overall survival (OS) and cancer-specific survival (CSS) were observed, and the Cox regression model was used to select potential factors that affect the prognosis of the patients with ICC.Results: Of the included patients, there were 142 patients and 256 patients in the cirrhotic and noncirrhotic groups, respectively. Additionally, 299 of 398 patients (75.1%) died following a median follow-up of 19 months (interquartile range [IQR],7, 43). The OS and CSS indicated advantage trend in the noncirrhotic group than the cirrhotic group in either the original cohort (OS: 17 vs 12 months, p = 0.023; CSS: 26 vs 15 months, p = 0.004) or the PSM (OS: 17 vs 12 months, p = 0.52; CSS: 22 vs 14 months, p = 0.15) or IPTW (OS: 20 vs 13 months, p = 0.163; CSS: 22 vs 15 months, p = 0.059) cohorts. Subgroup analyses displayed that the prognosis of patients who experienced surgery for ICC in the noncirrhotic group was better than that of the cirrhotic group with regard to OS and CSS.Conclusions: Collectively, it seems that the noncirrhotic patients have similar relative OS but better CSS compared with that of the cirrhotic patients.

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Section: Discussioncontrasting

confidence: 82%

“…[24][25][26] In addition, several previous studies have also demonstrated that tumor size is an important prognostic factor for ICC. 27,28 The multivariable Cox regression analysis of our study showed that surgery, AJCC TNM stage, and race of white were independent risk factors associated with of ICC instead of LND or tumor size.…”

Section: Resultsmentioning

confidence: 70%

Impact of cirrhosis on long‐term survival outcomes of patients with intrahepatic cholangiocarcinoma

et al. 2022

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“…Tumor size has been shown to be associated with worse prognosis for both HCCs and iCCAs in prior investigations. 29,30 Similarly, MELD score was independently associated with OS and PFS in our investigation, with prior studies also demonstrating functional impairment of the underlying liver having a significant impact on prognosis, regardless of the tumor stage. 31 It is likely that for patients with resectable lesions or multifocal tumors that are treatable with locoregional modalities, the presence of liver decompensation complicates these treatments, in turn affecting survival.…”

Section: Discussionsupporting

confidence: 80%

Comparing Survival Outcomes of Patients With LI‐RADS‐M Hepatocellular Carcinomas and Intrahepatic Cholangiocarcinomas

Kierans

Lafata

Ludwig

et al. 2022

Magnetic Resonance Imaging

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Background There is a sparsity of data evaluating outcomes of patients with Liver Imaging Reporting and Data System (LI‐RADS) (LR)‐M lesions. Purpose To compare overall survival (OS) and progression free survival (PFS) between hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (iCCA) meeting LR‐M criteria and to evaluate factors associated with prognosis. Study Type Retrospective. Subjects Patients at risk for HCC with at least one LR‐M lesion with histologic diagnosis, from 8 academic centers, yielding 120 patients with 120 LR‐M lesions (84 men [mean age 62 years] and 36 women [mean age 66 years]). Field Strength/Sequence A 1.5 and 3.0 T/3D T1‐weighted gradient echo, T2‐weighted fast spin‐echo. Assessment The imaging categorization of each lesion as LR‐M was made clinically by a single radiologist at each site and patient outcome measures were collected. Statistical Tests OS, PFS, and potential independent predictors were evaluated by Kaplan–Meier method, log‐rank test, and Cox proportional hazard model. A P value of <0.05 was considered significant. Results A total of 120 patients with 120 LR‐M lesions were included; on histology 65 were HCC and 55 were iCCA. There was similar median OS for patients with LR‐M HCC compared to patients with iCCA (738 days vs. 769 days, P = 0.576). There were no significant differences between patients with HCC and iCCA in terms of sex (47:18 vs. 37:18, P = 0.549), age (63.0 ± 8.4 vs. 63.4 ± 7.8, P = 0.847), etiology of liver disease (P = 0.202), presence of cirrhosis (100% vs. 100%, P = 1.000), tumor size (4.73 ± 3.28 vs. 4.75 ± 2.58, P = 0.980), method of lesion histologic diagnosis (P = 0.646), and proportion of patients who underwent locoregional therapy (60.0% vs. 38.2%, P = 0.100) or surgery (134.8 ± 165.5 vs. 142.5 ± 205.6, P = 0.913). Using multivariable analysis, nonsurgical compared to surgical management (HR, 4.58), larger tumor size (HR, 1.19), and higher MELD score (HR, 1.12) were independently associated with worse OS. Data Conclusion There was similar OS in patients with LR‐M HCC and LR‐M iCCA, suggesting that LR‐M imaging features may more closely reflect patient outcomes than histology. Evidence Level 3 Technical Efficacy Stage 5

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“…Early detection of ICC by screening is of vital importance in potential population with risk factors. Tumor size, R0 resection, lymph node metastasis, differentiation, adjuvant chemotherapy, CA19-9, T stage, PVTT, HBV infection/vaccination, and Eastern Cooperative Oncology Group performance status (ECOG-PS) have been reported as prognostic factors influencing survival outcomes of ICC in recent researches [2,31,37,40,[56][57][58]. We identified NAR, tumor size >5 cm, multiple tumors, and poor differentiation as independent risk factors for OS in ICC patients undergoing hepatectomy.…”

Section: Discussionmentioning

confidence: 96%

Anatomical Resection Improved the Outcome of Intrahepatic Cholangiocarcinoma: A Propensity Score Matching Analysis of a Retrospective Cohort

Wang

Ciren

Danzeng

et al. 2022

Journal of Oncology

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Background. Intrahepatic cholangiocarcinoma (ICC) is the second most common liver malignancy after hepatocellular carcinoma (HCC), with a dismal prognosis and high heterogeneity. The oncological advantages of anatomical resection (AR) and nonanatomical resection (NAR) in HCC have been studied, but surgical strategies for ICC remain controversial with insufficient investigations. Materials and Methods. From Jan 2013 to Dec 2016, 3880 consecutive patients were retrospectively reviewed from a single center. Patients with ICC undergoing AR or NAR have been enrolled according to inclusion and exclusion criteria. Propensity score matching (PSM) analysis was performed between two groups with a 1 : 1 ratio. The primary endpoint was overall survival (OS), and the secondary endpoints included disease-free survival (DFS), intraoperative patterns, postoperative morbidity, mortality, complications and recurrence. A prognostic nomogram was developed by a multivariate Cox proportion hazard model. Results. After PSM, 99 paired cases were selected from 276 patients enrolled in this study. Patients in the AR group achieved better 1-, 3-, and 5-year OS (70%, 46%, and 34%, respectively) and DFS (61%, 21%, and 10%, respectively) than patients in the NAR group with statistical significance after PSM analysis. The postoperative complications and recurrence patterns were comparable between the two groups. Multivariate analysis identified NAR, tumor size >5 cm, multiple tumors, and poor differentiation as independent risk factors for OS ( p < 0.05 ). Selected patients can benefit most from AR, according to subgroup analysis. A prognostic nomogram based on six independent risk factors for OS and factors with clinical significance was constructed to predict OS in ICC patients. Conclusion. AR improved the long-term survival of ICC with comparable postoperative complications and similar recurrence patterns. AR is suggested in ICC patients with sufficient remnant liver volume. In addition to surgery strategy, malignant characteristics of tumors are risk factors for ICC prognosis.

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Effect of Tumor Size on Long-Term Survival After Resection for Solitary Intrahepatic Cholangiocarcinoma

Cited by 8 publications

References 32 publications

Impact of cirrhosis on long‐term survival outcomes of patients with intrahepatic cholangiocarcinoma

Impact of cirrhosis on long‐term survival outcomes of patients with intrahepatic cholangiocarcinoma

Comparing Survival Outcomes of Patients With LI‐RADS‐M Hepatocellular Carcinomas and Intrahepatic Cholangiocarcinomas

Anatomical Resection Improved the Outcome of Intrahepatic Cholangiocarcinoma: A Propensity Score Matching Analysis of a Retrospective Cohort

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