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 p...

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Main Authors: Lei Wang, Manjun Deng, Qiao Ke, Jianying Lou, Shuguo Zheng, Xinyu Bi, Jianming Wang, Wei Guo, Fuyu Li, Jian Wang, Yamin Zheng, Jingdong Li, Shi Cheng, Weiping Zhou, Yongyi Zeng
Format: Article
Language:English
Published: Wiley 2020-04-01
Series:Cancer Medicine
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Online Access:https://doi.org/10.1002/cam4.2925
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author Lei Wang
Manjun Deng
Qiao Ke
Jianying Lou
Shuguo Zheng
Xinyu Bi
Jianming Wang
Wei Guo
Fuyu Li
Jian Wang
Yamin Zheng
Jingdong Li
Shi Cheng
Weiping Zhou
Yongyi Zeng
author_facet Lei Wang
Manjun Deng
Qiao Ke
Jianying Lou
Shuguo Zheng
Xinyu Bi
Jianming Wang
Wei Guo
Fuyu Li
Jian Wang
Yamin Zheng
Jingdong Li
Shi Cheng
Weiping Zhou
Yongyi Zeng
author_sort Lei Wang
collection DOAJ
description 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. Results A total of 412 patients were enrolled in this study, and 77 patients (18.9%) received AT, including 32 (7.8%) patients who received transarterial chemoembolization (TACE), 21 (5.1%) patients who received chemotherapy, 10 (2.4%) patients who received radiotherapy, and 14 (3.4%) patients who received adjuvant chemoradiotherapy. The median OS and DFS were both longer in the AT group than in the non‐AT group (43.0 months vs 21.0 months, P = .015; 16.0 months vs 11.0 months, P = .045, respectively), and the advantage of AT was confirmed for both the OS and DFS (P = .023; P = .046, respectively) after 1:2 PSM. Furthermore, based on the established nomogram, only “middle‐risk” patients receiving AT cherished a longer median OS (43.0 months vs 20.0 months, P = .033). In subgroup analyses that were stratified by different AT strategies, patients receiving postoperative chemotherapy had a longer median OS (37.0 months vs 21.0 months, P = .039), while patients receiving postoperative TACE had a longer median DFS (50.0 months vs 11.0 months, P = .007). Conclusion With the current data, we conclude that AT benefits ICC patients following radical resection, especially those “middle‐risk” patients, as evaluated by the established nomogram. However, exactly which patients are the most suitable for AT requires further study and validation.
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spelling doaj-art-019ed267d1e44e5391a0545c2d5c7aac2025-08-20T03:46:54ZengWileyCancer Medicine2045-76342020-04-01982674268510.1002/cam4.2925Postoperative adjuvant therapy following radical resection for intrahepatic cholangiocarcinoma: A multicenter retrospective studyLei Wang0Manjun Deng1Qiao Ke2Jianying Lou3Shuguo Zheng4Xinyu Bi5Jianming Wang6Wei Guo7Fuyu Li8Jian Wang9Yamin Zheng10Jingdong Li11Shi Cheng12Weiping Zhou13Yongyi Zeng14Department of Radiation Oncology Mengchao Hepatobiliary Hospital of Fujian Medical University Fuzhou ChinaDepartment of Hepatobiliary Surgery Mengchao Hepatobiliary Hospital of Fujian Medical University Fuzhou ChinaDepartment of Hepatobiliary Surgery Mengchao Hepatobiliary Hospital of Fujian Medical University Fuzhou ChinaDepartment of Hepatobiliary Surgery The Second Hospital Affiliated to Zhejiang University Hangzhou ChinaDepartment of Hepatobiliary Surgery The Southwest Hospital Affiliated to the Army Medical University Chongqing ChinaDepartment of Hepatobiliary Surgery Cancer Hospital Chinese Academy of Medical Sciences Beijing ChinaDepartment of Hepatobiliary Surgery Tongji Hospital Affiliated to Tongji Medical College Huazhong University of Science & Technology Wuhan Hubei ChinaDepartment of Hepatobiliary Surgery Beijing Friendship Hospital Affiliated to Capital Medical University Beijing ChinaDepartment of Hepatobiliary Surgery The West China Hospital of Sichuan University Chengdu ChinaDepartment of Hepatobiliary Surgery Renji Hospital Affiliated to Shanghai Jiaotong University Shanghai ChinaDepartment of Hepatobiliary Surgery Xuanwu Hospital Affiliated to Capital Medical University Beijing ChinaDepartment of Hepatobiliary Surgery The Affiliated Hospital of Chuanbei Medical University Nanchong ChinaDepartment of Hepatobiliary Surgery Tiantan Hospital Affiliated to Capital Medical University Beijing ChinaDepartment of Hepatobiliary Surgery Ⅲ Eastern Hepatobiliary Surgery Hospital Secondary Military Medical University Shanghai ChinaDepartment of Radiation Oncology Mengchao Hepatobiliary Hospital of Fujian Medical University Fuzhou ChinaAbstract 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. Results A total of 412 patients were enrolled in this study, and 77 patients (18.9%) received AT, including 32 (7.8%) patients who received transarterial chemoembolization (TACE), 21 (5.1%) patients who received chemotherapy, 10 (2.4%) patients who received radiotherapy, and 14 (3.4%) patients who received adjuvant chemoradiotherapy. The median OS and DFS were both longer in the AT group than in the non‐AT group (43.0 months vs 21.0 months, P = .015; 16.0 months vs 11.0 months, P = .045, respectively), and the advantage of AT was confirmed for both the OS and DFS (P = .023; P = .046, respectively) after 1:2 PSM. Furthermore, based on the established nomogram, only “middle‐risk” patients receiving AT cherished a longer median OS (43.0 months vs 20.0 months, P = .033). In subgroup analyses that were stratified by different AT strategies, patients receiving postoperative chemotherapy had a longer median OS (37.0 months vs 21.0 months, P = .039), while patients receiving postoperative TACE had a longer median DFS (50.0 months vs 11.0 months, P = .007). Conclusion With the current data, we conclude that AT benefits ICC patients following radical resection, especially those “middle‐risk” patients, as evaluated by the established nomogram. However, exactly which patients are the most suitable for AT requires further study and validation.https://doi.org/10.1002/cam4.2925adjuvant therapydisease‐free survivalintrahepatic cholangiocarcinomaoverall survivalpropensity score matching
spellingShingle Lei Wang
Manjun Deng
Qiao Ke
Jianying Lou
Shuguo Zheng
Xinyu Bi
Jianming Wang
Wei Guo
Fuyu Li
Jian Wang
Yamin Zheng
Jingdong Li
Shi Cheng
Weiping Zhou
Yongyi Zeng
Postoperative adjuvant therapy following radical resection for intrahepatic cholangiocarcinoma: A multicenter retrospective study
Cancer Medicine
adjuvant therapy
disease‐free survival
intrahepatic cholangiocarcinoma
overall survival
propensity score matching
title Postoperative adjuvant therapy following radical resection for intrahepatic cholangiocarcinoma: A multicenter retrospective study
title_full Postoperative adjuvant therapy following radical resection for intrahepatic cholangiocarcinoma: A multicenter retrospective study
title_fullStr Postoperative adjuvant therapy following radical resection for intrahepatic cholangiocarcinoma: A multicenter retrospective study
title_full_unstemmed Postoperative adjuvant therapy following radical resection for intrahepatic cholangiocarcinoma: A multicenter retrospective study
title_short Postoperative adjuvant therapy following radical resection for intrahepatic cholangiocarcinoma: A multicenter retrospective study
title_sort postoperative adjuvant therapy following radical resection for intrahepatic cholangiocarcinoma a multicenter retrospective study
topic adjuvant therapy
disease‐free survival
intrahepatic cholangiocarcinoma
overall survival
propensity score matching
url https://doi.org/10.1002/cam4.2925
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