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

Abstract

Background and Aims: The prognosis of intrahepatic cholangiocarcinoma (ICC) after radical resection is far from satisfactory; however, the clinical value of adjuvant therapy (AT) remains controversial. This multicenter study aimed to evaluate the clinical value of AT and identify potential patients who would be benefited from AT. Methods: Data from ICC patients who underwent radical resection were retrospectively collected from 12 hepatobiliary centers in China between December 2012 and December 2015. Patients were divided into AT and non-AT groups based on whether AT was administered or not. Overall survival (OS) and disease-free survival (DFS)were analyzed using the Kaplan-Meier method before and after 1:2 propensity score matching (PSM). Subgroup analyses were conducted based on the established staging systems. | 2675WANG et Al.

Prognostic Value of Lymph Node Dissection for Intrahepatic Cholangiocarcinoma Patients With Clinically Negative Lymph Node Metastasis: A Multi-Center Study From China

“…The optimal p-AT for resected ICC patients has not been determined, and it lacks clinical trial data to support a standard regimen in the postoperative management. Using the data from the multi-center study, we established a nomogram model (23), and found that only patients with "middle risk" could benefit from p-AT, which was confirmed by our recent meta-analysis based on the retrospective studies (34). Currently, adjuvant capecitabine chemotherapy with a duration of 6 months is recommended for patients with resected biliary tract cancer by ASCO guideline (35); while the 8 th NCCN guideline suggests observation or systemic therapy for ICC patients with R0 resection and fluoropyrimidine-/ gemcitabine-based chemotherapy for patients with R1 or pLNM (3).…”

“…Potential variables associated with the prognosis of HCC patients were determined according to previous studies ( 23 ). Tumor diameter (<5 cm vs. ≥5 cm) and tumor number (single vs. multiple) were categorized according to the American Joint of Cancer Committee (AJCC) system ( 23 ). HBV infection was defined as history of HBV infection, regardless of status of HBsAg and HBV-DNA ( 23 ).…”

“…Tumor diameter (<5 cm vs. ≥5 cm) and tumor number (single vs. multiple) were categorized according to the American Joint of Cancer Committee (AJCC) system ( 23 ). HBV infection was defined as history of HBV infection, regardless of status of HBsAg and HBV-DNA ( 23 ). The data of blood transfusion was extracted from anesthesia records, which typically included intraoperative transfusion of red blood cell and plasma ( 24 ).…”

“…The data of blood transfusion was extracted from anesthesia records, which typically included intraoperative transfusion of red blood cell and plasma ( 24 ). Age (<60 years vs. ≥60 years), blood loss (≤400 vs. >400 ml), surgical margin (wide vs. narrow), MF (no vs. yes), and differentiation (well-moderate vs. poor) were categorized as previous studies reported ( 23 ), and preoperative levels of CA19-9 (<37 vs. ≥37 U/ml) and CEA (<5 vs. ≥5 ng/ml) were categorized using cutoff value provided by clinical references ( 10 ).…”

High C-reactive protein/albumin ratio associated with reduced survival due to advanced stage of intrahepatic cholangiocarcinoma

“…ICC makes up approximately 5% of all primary liver cancer cases, and prognosis is very poor because of the possibility of relapse both outside and inside the liver, even when a patient undergoes liver resection at an early stage (12,13). Therefore, stratification of ICC patients based on the risk of recurrence would be helpful for identifying candidates for postoperative adjuvant therapy (14,15). In addition to clinicopathological findings (16,17) and surgical procedures (18,19), various types of predictive marker, such as aspartate aminotransferase/neutrophil ratio (20), platelet/ lymphocyte ratio (21), albumin/gGTP ratio (22), and neutrophil/lymphocyte ratio (23), have been reported as being negatively associated with patient survival after resection of ICC.…”