Prognostic factors in patients with advanced extrahepatic cholangiocarcinoma

Aktaş, Gökmen; Kuş, Tülay; Balkan, Ayhan; Metin, Taylan; Gülşen, Murat Taner; Abalı, Hüseyin

doi:10.1097/md.0000000000014556

Cited by 9 publications

(6 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We identified a number of factors that were associated with decreased OS after propensity score weighting and doubly robust estimation. The majority of these, such as Charlson scores of 1 or higher, positive LVSI, positive margins, lymph node positivity, tumors larger than 2 cm, age > 65, high-grade disease, and node positivity, are consistent with previously known prognostic factors in CCA [ 2 , 33 , 34 ]. Perhaps surprisingly, there was not an association of treatment modality with overall survival; however, this may be a result of insufficient power to detect a difference with only a small number of patients treated with radiation therapy alone.…”

Section: Discussionsupporting

confidence: 79%

The Implications of Treatment Delays in Adjuvant Therapy for Resected Cholangiocarcinoma Patients

Parsons

Lloyd

Johnson

et al. 2022

J Gastrointest Canc

View full text Add to dashboard Cite

Purpose The purpose of this study is to understand factors associated with timing of adjuvant therapy for cholangiocarcinoma and the impact of delays on overall survival (OS). Methods Data from the National Cancer Database (NCDB) for patients with non-metastatic bile duct cancer from 2004 to 2015 were analyzed. Patients were included only if they underwent surgery and adjuvant chemotherapy and/or radiotherapy (RT). Patients who underwent neoadjuvant or palliative treatments were excluded. Pearson’s chi-squared test and multivariate logistic regression analyses were used to assess the distribution of demographic, clinical, and treatment factors. After propensity score matching with inverse probability of treatment weighting, OS was compared between patients initiating therapy past various time points using Kaplan Meier analyses and doubly robust estimation with multivariate Cox proportional hazards modeling. Results In total, 7,733 of 17,363 (45%) patients underwent adjuvant treatment. The median time to adjuvant therapy initiation was 59 days (interquartile range 45–78 days). Age over 65, black and Hispanic race, and treatment with RT alone were associated with later initiation of adjuvant treatment. Patients with larger tumors and high-grade disease were more likely to initiate treatment early. After propensity score weighting, there was an OS decrement to initiation of treatment beyond the median of 59 days after surgery. Conclusions We identified characteristics that are related to the timing of adjuvant therapy in patients with biliary cancers. There was an OS decrement associated with delays beyond the median time point of 59 days. This finding may be especially relevant given the treatment delays seen as a result of COVID-19. Supplementary Information The online version contains supplementary material available at 10.1007/s12029-022-00820-4.

show abstract

Section: Discussionsupporting

confidence: 79%

The Implications of Treatment Delays in Adjuvant Therapy for Resected Cholangiocarcinoma Patients

Parsons

Lloyd

Johnson

et al. 2022

J Gastrointest Canc

View full text Add to dashboard Cite

show abstract

“…The majority of these, such as Charlson scores of 1 or higher, positive LVSI, positive margins, lymph node positivity, tumors larger than 2 cm, age > 65, high grade disease, and node positivity are consistent with previously known prognostic factors in CCA. 2,33,34 An important novel nding of our study is the nding that delays in initiation beyond the median time point of 59 days were associated with decrements in OS. While this has not been previously described in CCA, there are a number of malignancies in which delay to adjuvant therapy has been shown to be associated with worse outcomes.…”

Section: Discussionmentioning

confidence: 77%

The Implications of Treatment Delays In Adjuvant Therapy For Resected Cholangiocarcinoma Patients

Parsons

Lloyd

Johnson

et al. 2021

Preprint

View full text Add to dashboard Cite

Purpose: To understand factors associated with timing of adjuvant therapy for cholangiocarcinoma and the impact of delays on overall survival (OS).Methods: Data from the National Cancer Database (NCDB) for patients with non-metastatic bile duct cancer from 2004 to 2015 were analyzed. Patients were included only if they underwent surgery and adjuvant chemotherapy and/or radiotherapy (RT). Patients who underwent neoadjuvant or palliative treatments were excluded. Pearson’s chi-squared test and multivariate logistic regression analyses were used to assess the distribution of demographic, clinical, and treatment factors. After propensity-score matching with inverse probability of treatment weighting, OS was compared between patients initiating therapy past various time points using Kaplan Meier analyses and doubly-robust estimation with multivariate Cox proportional hazards modeling.Results: In total, 7,733 of 17,363 (45%) patients underwent adjuvant treatment. The median time to adjuvant therapy initiation was 59 days (interquartile range 45-78 days). Age over 65, black and Hispanic race, and treatment with RT alone were associated with later initiation of adjuvant treatment. Patients with larger tumors and high grade disease were more likely to initiate treatment early. After propensity score weighting, there was an OS decrement to initiation of treatment beyond the median of 59 days after surgery. Conclusions: We identified characteristics that are related to the timing of adjuvant therapy in patients with biliary cancers. There was an OS decrement associated with delays beyond the median time point of 59 days. This finding may be especially relevant given the treatment delays seen as a result of COVID-19.

show abstract

“…30 Transaminases have been reported to be associated with the development of hepatocellular cancer, intrahepatic and extrahepatic cholangiocarcinoma. [31][32][33] Epidemiological studies have examined the association of ALT with the risk of prostate cancer, but the findings have been conflicting. For example, a case-cohort study found that ALT levels were not associated with the risk of prostate cancer (hazard ratio (HR): 0.89, 95% CI: 0.73-1.07, P=0.212).…”

Section: Discussionmentioning

confidence: 99%

Genetically Predicted Circulating Concentrations of Alanine and Alanine Aminotransferase Were Associated with Prostate Cancer Risk

Yang¹,

Song²,

Yang³

et al. 2022

CLEP

View full text Add to dashboard Cite

Object Prostate cancer is one of the leading malignancies in men worldwide. Previous observational studies have linked amino acids and transaminase with altered risk of prostate cancer. However, whether these associations were causal remained unclear. Therefore, we conducted a Mendelian randomization (MR) to assess their potential causal associations. Methods Summary-level data for prostate cancer were obtained from a meta-analysis of genome-wide association studies (GWAS) including 79,148 prostate cancer cases and 61,106 controls of European descent. Instrumental variables (IVs) of amino acids and alanine aminotransferase (ALT) were obtained from a GWAS of 86,507 European individuals and a GWAS of 312,572 participants from the UK Biobank, respectively. MR analyses were performed using inverse-variance-weighted (IVW), likelihood-based, MR Pleiotropy RESidual Sum and Outlier (MR-PRESSO) test and MR-Egger regression. Results Genetically predicted circulating concentrations of alanine were associated with an increased risk of prostate cancer (odds ratio (OR): 1.16, 95% confidence interval (CI): 1.01–1.33, P =0.037 by IVW). Consistently, genetically predicted ALT was inversely associated with the risk of prostate cancer (OR: 0.43, 95% CI: 0.27–0.68, P =3.28×10 −4 by IVW). MR-Egger regression did not indicate evidence of directional pleiotropy and sensitivity analyses yielded consistent associations. Conclusion Our study revealed that genetically predicted circulating alanine and ALT levels were associated with an altered risk of prostate cancer, suggesting their potential roles in the development of prostate cancer. Whether targeting alanine, ALT or its downstream effectors are helpful in reducing prostate cancer incidence warrants further investigation.

show abstract

Prognostic factors in patients with advanced extrahepatic cholangiocarcinoma

Cited by 9 publications

References 23 publications

The Implications of Treatment Delays in Adjuvant Therapy for Resected Cholangiocarcinoma Patients

The Implications of Treatment Delays in Adjuvant Therapy for Resected Cholangiocarcinoma Patients

The Implications of Treatment Delays In Adjuvant Therapy For Resected Cholangiocarcinoma Patients

Genetically Predicted Circulating Concentrations of Alanine and Alanine Aminotransferase Were Associated with Prostate Cancer Risk

Contact Info

Product

Resources

About