Staging, prognostic factors and adjuvant therapy of intrahepatic cholangiocarcinoma after curative resection

2013 ◽  
Vol 34 (6) ◽  
pp. 953-960 ◽  
Author(s):  
Tao Li ◽  
Lun-Xiu Qin ◽  
Jian Zhou ◽  
Hui-Chuan Sun ◽  
Shuang-Jian Qiu ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Adjuvant Therapy ◽  
Intrahepatic Cholangiocarcinoma ◽  
Curative Resection

Treatment strategy for intrahepatic cholangiocarcinoma: From optimal surgical management to adjuvant therapy.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 392-392
Author(s):  
Yuji Morine ◽  
Mitsuo Shimada ◽  
Satoru Imura ◽  
Tetsuya Ikemoto ◽  
Yu Saito ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Bile Duct ◽  
Adjuvant Therapy ◽  
Intrahepatic Cholangiocarcinoma ◽  
Surgical Strategy ◽  
Bile Duct Resection ◽  
Extended Surgery ◽  
Period 2 ◽  
Significant Difference ◽  
Limited Surgery

392 Background: Surgical strategy for intrahepatic cholangiocarcinoma (IHCC) including systemic lymph nodes (LN) dissection is still controversial. Also, as adjuvant chemotherapy, we adopted this GFP regimen (GEM, 5-FU, and Cisplatin). We demonstrate the adequate surgical strategy, the effect of adjuvant therapy and the tumor malignancy evaluation. Methods: Study 1: Surgical strategy) In period 1 (1994.4-2004.3, n = 20), extended surgery was basically performed. In period 2 (2004.4~, n = 34), extent of hepatectomy is conducted according to tumor conditions. Swelling LN exterpation for macroscopic curability and bile duct resection for positive surgical margin are performed. Study2: Adjuvant GFP therapy) Induction of 2 cycles of GFP for advanced IHCC with prognostic factors (LN metastasis, intrahepatic metastasis and R2 resection). Study 3: Malignancy evaluation) Significance of serum CA19-9 levels, the relationships its levels and expressions ( immunostaining ) of hypoxic inducible factor 1 (HIF-1) /Histone deacetylase 1 (HDAC1) were evaluated. Results: Study 1) In period 2, LN dissection and extrahepatic bile duct resection were significantly infrequent. Surgical outcome is rather good regardless of limited surgery in recent periods (Period 1 vs. Period 2: 5yrs survival 24.9% vs. 34.9%, p = 0.119). There was no significant difference in recurrent pattern. Study 2) There were 32 cases had some kind of prognostic factors, and of these 11 patients received adjuvant GFP. Patient’s prognosis received adjuvant GFP was significantly prolonged (GFP vs. non GFP: 1yrs survival 71.6% vs. 45.0%, p < 0.02). Study 3) CA19-9 ( > 300U/ml) high group revealed the independent prognostic factor with stepwise model, as well as LN metastasis and vessels invasion. CA19-9 levels significantly correlated to HDAC1 and HIF-1 expressions. Conclusions: Extended surgery including LN dissection might not control malignant behavior of IHCC, and adjuvant GFP should be introduced in patients with poor prognostic factors.

scholarly journals P-0144 Adjuvant Therapy and Prognostic Factors for Biliary Tract Cancer Intrahepatic Cholangiocarcinoma: Single-Center Experience

2012 ◽  
Vol 23 ◽  
pp. iv72
Author(s):  
Joaquina Martinez-Galan ◽  
Javier Garcia Garcia ◽  
Karim Muffa K-Granero ◽  
José Antonio Ortega ◽  
Beatriz Gonzalez-Astorga ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Adjuvant Therapy ◽  
Biliary Tract ◽  
Intrahepatic Cholangiocarcinoma ◽  
Biliary Tract Cancer ◽  
Single Center ◽  
Tract Cancer ◽  
Single Center Experience

scholarly journals Perineural Invasion Independent Prognostic Factors in Patients with Gastric Cancer Undergoing Curative Resection

2012 ◽  
Vol 13 (7) ◽  
pp. 3149-3152 ◽  
Author(s):  
Fatih Selcukbiricik ◽  
Deniz Tural ◽  
Evin Buyukunal ◽  
Suheyla Serdengecti
Keyword(s):  
Gastric Cancer ◽  
Prognostic Factors ◽  
Curative Resection ◽  
Perineural Invasion

scholarly journals Prognostic value of preoperative inflammatory markers in patients with hepatocellular carcinoma underwent curative resection

2021 ◽  
Author(s):  
Wenlong Wu ◽  
Quancheng Wang ◽  
Dandan Han ◽  
Jianhui Li ◽  
Ye Nie ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Prognostic Factors ◽  
Inflammatory Markers ◽  
Curative Resection ◽  
Information Criterion ◽  
Gamma Glutamyl Transpeptidase ◽  
Roc Curve Analysis ◽  
Lymphocyte Ratio ◽  
Kaplan Meier ◽  
Glutamyl Transpeptidase

Abstract Background: The prognosis of hepatocellular carcinoma (HCC) is not optimistic. Our study focused on present inflammatory markers, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), gamma-glutamyl transpeptidase-to-platelet ratio (GPR), aspartate aminotransferase-to-lymphocyte ratio (ALR) and fibrinogen-to-albumin ratio (FAR), and aimed to explore their optimal combination for the prognosis of HCC after resection.Methods: 347 HCC patients with curative resection were enrolled. The optimal cutoff values of the inflammatory markers were calculated using receiver operating characteristic (ROC) curve analysis, and used to divide patients into two groups whose differences were compared by Kaplan-Meier analysis. Cox univariate and multivariate analysis were used to analyze the independent prognostic inflammatory markers. c2 test was chosen to determine the relationship between independent prognostic inflammatory markers and clinicopathological features. We created the combined scoring models and evaluated them by Cox univariate and multivariate methods. The concordance index (C-index), Akaike information criterion (AIC) and likelihood ratio were calculated to compare the models. The selected optimal inflammatory markers and their combinations were tested in different stages of HCC by Kaplan-Meier analysis.Results: ALR and GPR were independent prognostic factors for DFS; ALR, PLR, and GPR were independent prognostic factors for OS. The proposed GPR and ALR-GPR-PLR score models were independent predictors for DFS and OS, respectively.Conclusion: The preoperative GPR and ALR-GPR-PLR score models were independent predictors for DFS and OS, respectively, and performed well in stratifying patients with HCC. The higher score in the model, the worse the prognosis was.

scholarly journals Prognostic Factors and Clinical Characteristics of Duodenal Adenocarcinoma With Survival: A Retrospective Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Huapeng Sun ◽  
Yi Liu ◽  
Long Lv ◽  
Jingwen Li ◽  
Xiaofeng Liao ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Lymph Node ◽  
Curative Resection ◽  
Tumor Resection ◽  
Margin Status ◽  
High Expression ◽  
Duodenal Adenocarcinoma ◽  
Gastric Type ◽  
Duodenal Carcinoma

BackgroundTo evaluate the clinical risk factors that influence the overall survival in patients with duodenal adenocarcinoma (DA) after tumor resection.MethodsThis study retrospectively analyzed 188 patients who underwent tumor resection for DA between January 2005 and June 2020 at Xiangyang Central Hospital.ResultsThe median survival of the patients who underwent resectional operation was 54 months, longer than of those who underwent palliative surgery (20.8 months) (2,916.17; 95% CI, 916.3−9,280.5; p &lt; 0.001). Survival of non-ampullary duodenal carcinoma patients (50.3 months; 95% CI, 39.7−61.8) was similar to that of ampullary duodenal carcinoma patients (59.3 months; 95% CI, 38.6−66.7) but was significantly better than that of papillary adenocarcinoma patients (38.9 months; 95% CI, 29.8−54.8; p = 0.386). Those with intestinal-type ductal adenocarcinomas had a longer median overall survival than those with the gastric type (61.8 vs. 46.7 months; p &lt; 0.01) or pancreatic type (32.2 months; p &lt; 0.001). Clinical DA samples had significantly diverse expressions of ATG12, IRS2, and IGF2. Higher expressions of the ATG12 and IRS2 proteins were significantly correlated with worse survival. Multivariate Cox regression analysis revealed that lymph node metastasis (hazard ratio (HR), 6.44; 95% CI, 3.68−11.27; p &lt; 0.0001), margin status (HR, 4.94; 95% CI, 2.85−8.54; p &lt; 0.0001), and high expression of ATG12 (HR, 1.89; 95% CI, 1.17−3.06; p = 0.0099) were independent prognostic factors negatively associated with survival in patients undergoing curative resection. There was no survival difference between the groups with ampullary, non-ampullary, and papillary adenocarcinomas treated with adjuvant chemotherapy (p = 0.973).ConclusionGastric/pancreatic type, high expression of ATG12, lymph node metastases, and margin status were negative prognosticators of survival in patients with DAs than in those with tumor anatomical location. Curative resection is the best treatment option for appropriate patients.

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