Recurrence after curative resection for intrahepatic cholangiocarcinoma: how to predict the chance of repeat hepatectomy?

BackgroundThe purpose of this study was to compare the efficacy and safety of transarterial chemoembolization (TACE) in combination with radiofrequency ablation (RFA) (TACE-RFA) and repeat hepatectomy in the treatment of recurrent hepatocellular carcinoma (HCC) after curative resection.MethodsThis retrospective study evaluated consecutive medical records of patients who received either TACE-RFA or repeat hepatectomy between January 2010 and May 2021. Overall survival (OS), progression-free survival (PFS), and complications were compared.ResultsOf the 2672 patients who received either TACE-RFA or repeat hepatectomy, 111 eligible patients were included in our study, 63 in the TACE-RFA group and 48 in the repeat hepatectomy group. The median OS was 38 months in the TACE-RFA group and 42 months in the repeat hepatectomy group, with no statistically difference between the two groups (P=0.45). Meanwhile, there was also no statistically significant difference in PFS between the two groups (P=0.634). Although both groups achieved similar outcomes, the rate of major complications was significantly higher in the repeat hepatectomy group (P=0.003).ConclusionsPatients with recurrent HCC in the TACE-RFA group and the repeat hepatectomy group had similar OS and PFS regardless of the patient’s tumor diameter, but the TACE-RFA group was safer and more minimally invasive.

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Peritumoral plasmacytoid dendritic cells predict a poor prognosis for intrahepatic cholangiocarcinoma after curative resection

Cancer Cell International ◽

10.1186/s12935-020-01676-z ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Zhi-Qiang Hu ◽

Zheng-Jun Zhou ◽

Chu-Bin Luo ◽

Hao-Yang Xin ◽

Jia Li ◽

...

Keyword(s):

Overall Survival ◽

Dendritic Cells ◽

Intrahepatic Cholangiocarcinoma ◽

Poor Prognosis ◽

Curative Resection ◽

Carbohydrate Antigen ◽

Plasmacytoid Dendritic Cells ◽

Gamma Glutamyl Transferase ◽

Advanced Tumor ◽

Glutamyl Transferase

Abstract Background Plasmacytoid dendritic cells (pDCs) are present in various primary and metastatic human neoplasms; however, their clinical significance in intrahepatic cholangiocarcinoma is not clear. Methods To evaluate pDCs’ distributions in and around tumors as well as their potential function and predictive value for prognosis in patients undergoing curative resection, we performed immunohistochemistry to examine the expression of pDC marker BDCA2, and CD3, CD4, CD8 and Foxp3 in intratumoral and peritumoral tissues from 359 patients with intrahepatic cholangiocarcinoma and compared with prognostic and clinicopathologic factors. Results Results showed that patients with high numbers of BDCA2+ pDCs in peritumoral tissues were more likely to have elevated levels of carbohydrate antigen 19-9 and gamma-glutamyl transferase, larger and more tumors, advanced tumor-node-metastasis staging, more vascular/bile duct invasion, and lymphatic metastasis in association with greater chance of recurrence and shorter overall survival. Peritumoral tissues with larger numbers of pDCs also showed increased Foxp3+ regulatory T cell infiltration, both of which were found to be independent factors for predicting time to recurrence and overall survival. By contrast, patient outcomes were not associated with the presence of intratumoral pDCs. Conclusions Peritumoral pDC infiltration may indicate an immune tolerogenic peritumor microenvironment and can be used to predict a poor prognosis for patients undergoing curative resection for intrahepatic cholangiocarcinoma.

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Perineural invasion as a prognostic factor for intrahepatic cholangiocarcinoma after curative resection and a potential indication for postoperative chemotherapy: a retrospective cohort study

BMC Cancer ◽

10.1186/s12885-020-06781-w ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 1

Author(s):

Zeyu Zhang ◽

Yufan Zhou ◽

Kuan Hu ◽

Dong Wang ◽

Zhiming Wang ◽

...

Keyword(s):

Cohort Study ◽

Prognostic Factor ◽

Intrahepatic Cholangiocarcinoma ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Curative Resection ◽

Perineural Invasion ◽

Postoperative Chemotherapy

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The long-term outcomes after curative resection for mass-forming intrahepatic cholangiocarcinoma associated with hepatitis C viral infection: A multicenter analysis by Osaka Hepatic Surgery Study Group

Journal of Surgical Oncology ◽

10.1002/jso.23611 ◽

2014 ◽

Vol 110 (2) ◽

pp. 176-181 ◽

Cited By ~ 5

Author(s):

Takahiro Uenishi ◽

Hiroaki Nagano ◽

Shigeru Marubashi ◽

Michihiro Hayashi ◽

Fumitoshi Hirokawa ◽

...

Keyword(s):

Hepatitis C ◽

Viral Infection ◽

Intrahepatic Cholangiocarcinoma ◽

Curative Resection ◽

Study Group ◽

Hepatic Surgery ◽

Long Term Outcomes ◽

Multicenter Analysis

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Diffuse reduction of spleen density is a novel prognostic marker for intrahepatic cholangiocarcinoma after curative resection

World Journal of Gastrointestinal Oncology ◽

10.4251/wjgo.v13.i8.929 ◽

2021 ◽

Vol 13 (8) ◽

pp. 929-940

Author(s):

Li-Ming Deng ◽

Yi Wang ◽

Jin-Huan Yang ◽

Jia-Liang Li ◽

Zi-Yan Chen ◽

...

Keyword(s):

Prognostic Marker ◽

Intrahepatic Cholangiocarcinoma ◽

Curative Resection

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Preoperatively elevated RDW-SD and RDW-CV predict favorable survival in intrahepatic cholangiocarcinoma patients after curative resection

10.21203/rs.3.rs-37317/v1 ◽

2020 ◽

Author(s):

Xingchen Li ◽

Qichen Chen ◽

Xinyu Bi ◽

Jianjun Zhao ◽

Zhiyu Li ◽

...

Keyword(s):

Multivariate Analysis ◽

Intrahepatic Cholangiocarcinoma ◽

Curative Resection ◽

Radical Resection ◽

Distribution Width ◽

Cox Proportional Hazard ◽

Intervention Measures ◽

Kaplan Meier ◽

Preoperative Serum ◽

Cox Proportional Hazard Models

Abstract Background Recent studies suggest red blood cell distribution width (RDW) was a prognostic factor in various types of cancer patients, although the results are controversial. The objective of this study was to investigate the significance of RDW in patients with Intrahepatic cholangiocarcinoma (ICC) after radical resection. Method: The relationship between the preoperative serum RDW value and clinic pathological characteristics was analyzed in 157 ICC patients between January 2012 and June 2018 who underwent curative resection. X-tile software was used to determine 40.2 fl, 12.6% as the optimal cut-off value for RDW-SD and RDW-CV respectively. 153 patients were classified into the low RDW-SD (≤ 40.2, n = 53) group and the high RDW-SD (> 40.2, n = 104) group, low RDW-CV (≤ 12.6, n = 94) group and the high RDW-CV (> 12.6, n = 63). Based on the RDW-SD combined with RDW-CV(SCC), classified into SCC = 0, 1 and 2 group. Kaplan-Meier survival analysis and Cox proportional hazard models were used to examine the effect of RDW on survival. Results Kaplan-Meier curve analysis showed that Patients with RDW-SD > 40.2 were significantly associated with better OS (P = 0.004, median OS: 68.0 months versus 17.0 months). Patients with RDW-CV > 12.6 were significantly associated with better OS (P = 0.030, median OS: not reach versus 22.0 months). Compared with a SCC = 0 or SCC = 1, SCC = 2 was significantly associated with better OS (P < 0.001, median OS: not reach versus 33.0 months versus 16, respectively). In the multivariate analysis, RDW-SD > 40.2 fl (HR = 0.446, 95% CI: 0.262–0.760, P = 0.003), RDW-CV > 12.6% (HR = 0.425, 95%CI: 0.230–0.783, P = 0.006), SCC = 2 (HR = 0.270, 95%CI: 0.133–0.549, P < 0.001) were associated with favorable OS. The multivariate analysis showed RDW-SD, RDW-CV and SCC level were not independent prognostic factors for PFS. Conclusions Preoperative low levels of RDW are associated with poor survival in ICC after curative resection. This provides a new way for predicting the prognosis of ICC patients and more targeted intervention measures.

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