Zhufeng Lu1, Shuang Liu2, Yong Yi2, Xiaochun Ni2, Jiaxing Wang2, Jinlong Huang2, Yipeng Fu2, Ya Cao2, Jian Zhou2, Jia Fan2, Shuangjian Qiu3. 1. Liver Cancer Institute and Zhongshan Hospital, Fudan University, Key Laboratory of Carcinogenesis and Cancer Invasion (Fudan University), Ministry of Education, 180 Feng Lin Road, Shanghai 200032, People's Republic of China; Department of Anesthesiology, Zhongshan Hospital, Fudan University, 180 Feng Lin Road, Shanghai 200032, People's Republic of China. 2. Liver Cancer Institute and Zhongshan Hospital, Fudan University, Key Laboratory of Carcinogenesis and Cancer Invasion (Fudan University), Ministry of Education, 180 Feng Lin Road, Shanghai 200032, People's Republic of China. 3. Liver Cancer Institute and Zhongshan Hospital, Fudan University, Key Laboratory of Carcinogenesis and Cancer Invasion (Fudan University), Ministry of Education, 180 Feng Lin Road, Shanghai 200032, People's Republic of China. Electronic address: qiu.shuangjian@zs-hospital.sh.cn.
Abstract
BACKGROUND: The postoperative prognosis of patients with intrahepatic cholangiocarcinoma (ICC) is far from satisfactory. Whether postoperative adjuvant transcatheter arterial chemoembolization (TACE) is effective for patients with ICC after R0 liver resection remains controversial. MATERIALS AND METHODS: We retrospectively reviewed the data of 272 patients with ICC who received a radical hepatectomy at our center between 2000 and 2011. After the propensity score of postoperative TACE was calculated, 75 patients who received TACE were matched at a 1:2 ratios with 150 patients who did not receive TACE. Univariate and multivariate Cox analyses were performed to identify the independent predictors of overall survival. RESULTS: The postoperative protective effect of adjuvant TACE was significantly influenced by serum gamma-glutamyl transferase (GGT) levels (P for interaction = 0.026). Postoperative TACE was not a significant predictor of overall survival (hazard ratio = 0.89, P = 0.704) in patients with GGT levels ≤ 54 U/L. Postoperative TACE was a significant predictor of overall survival in patients with GGT levels >54 U/L (hazard ratio = 0.44, P = 0.001). Regarding short-term outcomes, a total of 74 patients (32.9%) had varying degrees of complications, and the majority of these complications were grade I (18.7%) or II (10.2%). CONCLUSION: The safety of postoperative TACE was validated, and the results suggest that only patients with elevated serum GGT levels will benefit from this treatment following curative liver resection for ICC.
BACKGROUND: The postoperative prognosis of patients with intrahepatic cholangiocarcinoma (ICC) is far from satisfactory. Whether postoperative adjuvant transcatheter arterial chemoembolization (TACE) is effective for patients with ICC after R0 liver resection remains controversial. MATERIALS AND METHODS: We retrospectively reviewed the data of 272 patients with ICC who received a radical hepatectomy at our center between 2000 and 2011. After the propensity score of postoperative TACE was calculated, 75 patients who received TACE were matched at a 1:2 ratios with 150 patients who did not receive TACE. Univariate and multivariate Cox analyses were performed to identify the independent predictors of overall survival. RESULTS: The postoperative protective effect of adjuvant TACE was significantly influenced by serum gamma-glutamyl transferase (GGT) levels (P for interaction = 0.026). Postoperative TACE was not a significant predictor of overall survival (hazard ratio = 0.89, P = 0.704) in patients with GGT levels ≤ 54 U/L. Postoperative TACE was a significant predictor of overall survival in patients with GGT levels >54 U/L (hazard ratio = 0.44, P = 0.001). Regarding short-term outcomes, a total of 74 patients (32.9%) had varying degrees of complications, and the majority of these complications were grade I (18.7%) or II (10.2%). CONCLUSION: The safety of postoperative TACE was validated, and the results suggest that only patients with elevated serum GGT levels will benefit from this treatment following curative liver resection for ICC.
Authors: Ka Wing Ma; Tan To Cheung; Brian Leung; Brian Wong Hoi She; Kenneth Siu Ho Chok; Albert Chi Yan Chan; Wing Chiu Dai; Chung Mau Lo Journal: Medicine (Baltimore) Date: 2019-02 Impact factor: 1.817