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Staging, prognostic factors and adjuvant therapy of intrahepatic cholangiocarcinoma after curative resection.
Liver Int. 2014 Jul; 34(6):953-60.LI

Abstract

BACKGROUND & AIMS

Prognostic factors and adjuvant therapy of intrahepatic cholangiocarcinoma (ICC) after curative resection were not clear. We aim to analyse prognostic factors after curative resection and evaluate adjuvant therapy and survival based on the new staging system.

METHODS

A retrospective analysis of 283 patients who underwent surgical exploration for ICC was performed. Staging was performed according to the 7th edition AJCC staging manual. Univariate and multivariate analyses were used to evaluate independent prognostic factors.

RESULTS

The difference for OS at different TNM stages after R0 resection was significant (P < 0.001). Despite regional lymph node metastasis, tumour number and vascular invasion, serum GGT level was also an independent prognostic factor for OS of patients after R0 resection. The incidence of biliary and vascular invasion was significantly higher in high GGT group than in normal GGT group. Factors predictive of recurrence were multiple tumours and regional lymph node metastasis. After R0 resection, adjuvant TACE not only did not improve the OS of patients at TNM stage I (P = 0.508), but significantly promoted recurrence of these patients (P = 0.006). Only patients at TNM stage II, III and IV benefited from adjuvant TACE for longer survival, while the recurrence rates were not affected.

CONCLUSIONS

The new staging system can predict the survival of ICC patients after R0 resection. High GGT level may be suggestive of biliary and vascular invasion and was an independent risk factor for OS after R0 resection. Adjuvant TACE may be indicated only for patients at advanced stages for better survival.

Authors+Show Affiliations

Department of General Surgery, Qilu Hospital, Shandong University, Jinan, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24134199

Citation

Li, Tao, et al. "Staging, Prognostic Factors and Adjuvant Therapy of Intrahepatic Cholangiocarcinoma After Curative Resection." Liver International : Official Journal of the International Association for the Study of the Liver, vol. 34, no. 6, 2014, pp. 953-60.
Li T, Qin LX, Zhou J, et al. Staging, prognostic factors and adjuvant therapy of intrahepatic cholangiocarcinoma after curative resection. Liver Int. 2014;34(6):953-60.
Li, T., Qin, L. X., Zhou, J., Sun, H. C., Qiu, S. J., Ye, Q. H., Wang, L., Tang, Z. Y., & Fan, J. (2014). Staging, prognostic factors and adjuvant therapy of intrahepatic cholangiocarcinoma after curative resection. Liver International : Official Journal of the International Association for the Study of the Liver, 34(6), 953-60. https://doi.org/10.1111/liv.12364
Li T, et al. Staging, Prognostic Factors and Adjuvant Therapy of Intrahepatic Cholangiocarcinoma After Curative Resection. Liver Int. 2014;34(6):953-60. PubMed PMID: 24134199.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Staging, prognostic factors and adjuvant therapy of intrahepatic cholangiocarcinoma after curative resection. AU - Li,Tao, AU - Qin,Lun-Xiu, AU - Zhou,Jian, AU - Sun,Hui-Chuan, AU - Qiu,Shuang-Jian, AU - Ye,Qing-Hai, AU - Wang,Lu, AU - Tang,Zhao-You, AU - Fan,Jia, Y1 - 2013/11/20/ PY - 2013/02/23/received PY - 2013/10/13/accepted PY - 2013/10/19/entrez PY - 2013/10/19/pubmed PY - 2015/2/24/medline KW - adjuvant therapy KW - intrahepatic cholangiocarcinoma KW - prognosis KW - recurrence KW - risk factors SP - 953 EP - 60 JF - Liver international : official journal of the International Association for the Study of the Liver JO - Liver Int VL - 34 IS - 6 N2 - BACKGROUND & AIMS: Prognostic factors and adjuvant therapy of intrahepatic cholangiocarcinoma (ICC) after curative resection were not clear. We aim to analyse prognostic factors after curative resection and evaluate adjuvant therapy and survival based on the new staging system. METHODS: A retrospective analysis of 283 patients who underwent surgical exploration for ICC was performed. Staging was performed according to the 7th edition AJCC staging manual. Univariate and multivariate analyses were used to evaluate independent prognostic factors. RESULTS: The difference for OS at different TNM stages after R0 resection was significant (P < 0.001). Despite regional lymph node metastasis, tumour number and vascular invasion, serum GGT level was also an independent prognostic factor for OS of patients after R0 resection. The incidence of biliary and vascular invasion was significantly higher in high GGT group than in normal GGT group. Factors predictive of recurrence were multiple tumours and regional lymph node metastasis. After R0 resection, adjuvant TACE not only did not improve the OS of patients at TNM stage I (P = 0.508), but significantly promoted recurrence of these patients (P = 0.006). Only patients at TNM stage II, III and IV benefited from adjuvant TACE for longer survival, while the recurrence rates were not affected. CONCLUSIONS: The new staging system can predict the survival of ICC patients after R0 resection. High GGT level may be suggestive of biliary and vascular invasion and was an independent risk factor for OS after R0 resection. Adjuvant TACE may be indicated only for patients at advanced stages for better survival. SN - 1478-3231 UR - https://www.unboundmedicine.com/medline/citation/24134199/Staging_prognostic_factors_and_adjuvant_therapy_of_intrahepatic_cholangiocarcinoma_after_curative_resection_ L2 - https://doi.org/10.1111/liv.12364 DB - PRIME DP - Unbound Medicine ER -