Chemotherapy for surgically resected intrahepatic cholangiocarcinoma: Influence of lymph node status on treatment efficacy.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 353-353
Author(s):  
John Thomas Miura ◽  
Fabian McCartney Johnston ◽  
Susan Tsai ◽  
Ben George ◽  
James P. Thomas ◽  
...  
Keyword(s):  
Lymph Node ◽  
Intrahepatic Cholangiocarcinoma ◽  
Proportional Hazards ◽  
Treatment Strategies ◽  
Cox Proportional Hazards ◽  
Lymph Node Status ◽  
Advanced Tumor Stage ◽  
Curative Intent ◽  
Node Status ◽  
Advanced Tumor

353 Background: High rates of recurrence following surgery (S) for intrahepatic cholangiocarcinoma (ICC) have prompted treatment strategies that incorporate chemotherapy (CT). However the benefit of CT remains poorly defined. The present study sought to determine the survival impact of CT for surgically resected ICC. Methods: Patients with non-metastatic ICC that underwent curative intent surgery (R0) were identified from the National Cancer Database (1998-2011) and stratified by receipt of CT. Log rank tests and cox proportional hazards models were used to examine overall survival (OS). Results: A total of 1,729 patients were identified (median age: 66 years, 53% female); 520 (30.1%) received CT. Patients receiving CT were younger (61 vs 66 years, p<0.01), had larger tumors (>5cm: 47 vs 40%, p<0.01), and had a higher frequency of lymph node metastasis (23 vs 12%, p<0.01). However, lymph node evaluation was not conducted in 30% (n=519) of the collective cohort. In the entire series, there was no difference in unadjusted median OS between patients receiving CT compared to S alone (30 vs 32 months, p=0.31). In multivariate models, advanced tumor stage and lymph node status (p<0.05) were associated with shorter OS. When stratified by lymph node status, CT demonstrated a significant improvement in median OS among N1 patients (HR: 0.47, 95%CI: 0.25-0.87; p=0.02). In contrast, patients with N0 disease derived no benefit from CT (HR: 0.95, 95%CI: 0.65-1.39; p=0.80). Conclusions: The use of CT was associated with a survival benefit only for ICC patients with nodal metastasis. Assessment of lymph nodes at the time of surgical resection is critical when attempting to identify a subgroup of patients best suited for CT.

scholarly journals Clinical significance of PD-L1 expression in serum-derived exosomes in NSCLC patients

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Chuling Li ◽  
Chuwei Li ◽  
Chunchun Zhi ◽  
Wenjun Liang ◽  
Xuan Wang ◽  
...  
Keyword(s):  
Lymph Node ◽  
Tumor Size ◽  
Positive Lymph Node ◽  
Bioactive Molecules ◽  
Lymph Node Status ◽  
Advanced Tumor Stage ◽  
Node Status ◽  
Advanced Tumor ◽  
Nsclc Patients ◽  
The Impact

Abstract Background Exosomes are 50–150 nm endocytic vesicles secreted by almost all type of cells that carry bioactive molecules from host. These small vesicles are considered to be novel cross-talk circuits established by tumor cells and tumor microenvironment. Previous studies have shown certain biological influence of exosomal programmed cell-death ligand 1 (Exo-PD-L1) on immune suppression and dysfunction. The aim of the current study was to investigate the impact of Exo-PD-L1 and soluble PD-L1 (sPD-L1) on non-small cell lung cancer (NSCLC) and explore the concordance between Exo-PD-L1 and PD-L1 expression in matched tumor tissues in NSCLC patients. Methods 85 consecutive patients from April 2017 to December 2017 at General Hospital of Eastern Command Theatre who were primarily diagnosed with NSCLC and 27 healthy individuals were enrolled in this study. Two milliliters of whole blood samples were collected from each participant and further centrifuged. Exosomes were derived from serum using the commercial kit (Total Exosome Isolation Kit), which was further identified by Western blotting analysis (CD63/TSG101), transmission electron microscope analysis (TEM) and nanoparticle tracking analysis (NTA). Exosomes were next solubilized for Exo-PD-L1 detection by enzyme-linked immuno-sorbent assay (ELISA). PD-L1 expression in matched tissue were assessed by PD-L1 immunohistochemistry (IHC) (clone 28-8) assay. Tumor proportion score (TPS) ≥ 1% was deemed as “positive” in this study and TPS < 1% was deemed as “negative”. Written informed consent were obtained before acquisition of all data and biological sample. Data were analyzed using SPSS 20.0 and Graphpad Prism 5 software. Chi square test was conducted to estimate the correlation between Exo-PD-L1 levels, sPD-L1 levels, PD-L1 IHC profiles and clinicopathological features. For all analysis, a two-sided p < 0.05 was considered significant statistically. Results Exo-PD-L1 levels were higher in NSCLC patients with advanced tumor stage, larger tumor size (> 2.5 cm) (p < 0.001), positive lymph node status (p < 0.05) and distant metastasis (p < 0.05). In contrast, sPD-L1 levels were not different between NSCLC patients and healthy donors, it was not correlated with any clinicopathologic features except for tumor size (> 2.5 cm) (p < 0.05). In addition, Exo-PD-L1 levels showed slight correlation with sPD-L1 levels (Spearman’s correlation at r = 0.3, p = 0.0027) while no correlation with PD-L1 IHC profiles was detected. Conclusions In conclusion, Exo-PD-L1, but not sPD-L1, was correlated with NSCLC disease progression, including tumor size, lymph node status, metastasis and TNM stage. However, Exo-PD-L1 was not associated with PD-L1 IHC status.

Is Radiotherapy Warranted Following Intrahepatic Cholangiocarcinoma Resection? The Impact of Surgical Margins and Lymph Node Status on Survival

2016 ◽  
Vol 23 (S5) ◽  
pp. 912-920 ◽  
Author(s):  
Abdulrahman Y. Hammad ◽  
Nick G. Berger ◽  
Dan Eastwood ◽  
Susan Tsai ◽  
Kiran K. Turaga ◽  
...  
Keyword(s):  
Lymph Node ◽  
Intrahepatic Cholangiocarcinoma ◽  
Surgical Margins ◽  
Lymph Node Status ◽  
Node Status ◽  
The Impact

scholarly journals The role of lymph node dissection in intrahepatic cholangiocarcinoma: a multicenter retrospective study

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hanjie Hu ◽  
Gang Xu ◽  
Shunda Du ◽  
Zhiwen Luo ◽  
Hong Zhao ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Lymph Node Dissection ◽  
Intrahepatic Cholangiocarcinoma ◽  
Proportional Hazards ◽  
Disease Free Survival ◽  
Cox Proportional Hazards ◽  
Node Dissection ◽  
Nccn Guidelines

Abstract Background Lymph node dissection (LND) is of great significance in intrahepatic cholangiocarcinoma (ICC). Although the National Comprehensive Cancer Network (NCCN) guidelines recommend routine LND in ICC, the effects of LND remains controversial. This study aimed to explore the role of LND and some related issues and of in ICC. Methods Patients were identified in two Chinese academic centers. Inverse probability of treatment weighting (IPTW) was used to reduce bias. Kaplan–Meier curves and Cox proportional hazards models were used to compare overall survival (OS) and disease-free survival (DFS). Results Of 232 patients, 177 (76.3%) underwent LND, and 71 (40.1%) had metastatic lymph nodes. A minimum of 6 lymph nodes were dissected in 66 patients (37.3%). LND did not improve the prognosis of ICC. LNM > 3 may have worse OS and DFS than LNM 1–3, especially in the LND >  = 6 group. For patients who did not underwent LND, the adjuvant treatment group had better OS and DFS. Conclusions The proportions of patients who underwent LND and removed >  = 6 lymph nodes were not high enough. LND has no definite predictive effect on prognosis. Patients with 4 or more LNMs may have a worse prognosis than patients with 1–3 LNMs. Adjuvant therapy may benefit patients of nLND.

scholarly journals Treatment of Intrahepatic Cholangiocarcinoma—A Multidisciplinary Approach

Cancers ◽  
2022 ◽  
Vol 14 (2) ◽  
pp. 362
Author(s):  
Felix Krenzien ◽  
Nora Nevermann ◽  
Alina Krombholz ◽  
Christian Benzing ◽  
Philipp Haber ◽  
...  
Keyword(s):  
Liver Resection ◽  
Intrahepatic Cholangiocarcinoma ◽  
Therapeutic Option ◽  
Treatment Strategies ◽  
Oncological Outcome ◽  
Advanced Tumor Stage ◽  
National Guidelines ◽  
Distal Cholangiocarcinoma ◽  
Delay In Diagnosis ◽  
Advanced Tumor

Intrahepatic cholangiocarcinoma (iCC) is distinguished as an entity from perihilar and distal cholangiocarcinoma and gallbladder carcinoma. Recently, molecular profiling and histopathological features have allowed further classification. Due to the frequent delay in diagnosis, the prognosis for iCC remains poor despite major technical advances and multimodal therapeutic approaches. Liver resection represents the therapeutic backbone and only curative treatment option, with the functional residual capacity of the liver and oncologic radicality being deciding factors for postoperative and long-term oncological outcome. Furthermore, in selected cases and depending on national guidelines, liver transplantation may be a therapeutic option. Given the often advanced tumor stage at diagnosis or the potential for postoperative recurrence, locoregional therapies have become increasingly important. These strategies range from radiofrequency ablation to transarterial chemoembolization to selective internal radiation therapy and can be used in combination with liver resection. In addition, adjuvant and neoadjuvant chemotherapies as well as targeted therapies and immunotherapies based on molecular profiles can be applied. This review discusses multimodal treatment strategies for iCC and their differential use.

scholarly journals Serum Tie-1 is a Valuable Marker for Predicting the Progression and Prognosis of Cervical Cancer

2021 ◽  
Vol 27 ◽  
Author(s):  
Rui Bai ◽  
Bowen Diao ◽  
Kaili Li ◽  
Xiaohan Xu ◽  
Ping Yang
Keyword(s):  
Cervical Cancer ◽  
Cancer Patients ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Enzyme Linked Immunosorbent Assay ◽  
Advanced Tumor Stage ◽  
Healthy Controls ◽  
Cervical Lesions ◽  
Advanced Tumor ◽  
Valuable Marker

Objective: To investigate whether serum Tie-1 (sTie-1) is a valuable marker for predicting progression and prognosis of cervical cancer.Methods: Enzyme-linked immunosorbent assay (ELISA) was used to detect serum sTie-1 concentrations in 75 cervical cancer patients, 40 cervical intraepithelial neoplasia (CIN) patients, and 55 healthy controls without cervical lesions, and sTie-1 levels were compared between the groups. Receiver operating characteristic curves was used to evaluate the diagnostic value of sTie-1. The relationship between sTie-1 concentrations in patients with cervical cancer and clinicopathological features and prognosis were analyzed, and the risk factors for postoperative recurrence were determined using univariate and multivariable Cox proportional hazards regression.Results: We found that sTie-1 concentrations gradually increased according to lesion severity (i.e., cancer vs. CIN; p &lt; 0.05) and were significantly elevated in adenocarcinoma compared with healthy controls. sTie-1 levels strongly distinguished between cervical cancer patients and the healthy controls (area under the curve = 0.846; cut-off value = 1,882.64 pg/ml; sensitivity = 74.6%; specificity = 96.4%). Moreover, sTie-1 levels in cervical cancer patients were significantly associated with tumor size, advanced tumor stage, lymph node metastasis, and reduced 4-years progression-free survival. Cervical cancer patients with high sTie-1 concentrations had a 3.123-fold [95% confidence interval (CI): 1.087–8.971, p = 0.034] higher risk for tumor recurrence.Conclusions: Elevated sTie-1 levels in patients with cervical carcinoma were associated with tumor progression and poor prognosis, indicating that sTie-1 may be a valuable marker for predicting progression and prognosis of cervical cancer.

scholarly journals Impact of lymph node status in patients with intrahepatic cholangiocarcinoma treated by major hepatectomy: a review of the National Cancer Database

HPB ◽  
2016 ◽  
Vol 18 (1) ◽  
pp. 79-87 ◽  
Author(s):  
Zeljka Jutric ◽  
W. Cory Johnston ◽  
Helena M. Hoen ◽  
Pippa H. Newell ◽  
Maria A. Cassera ◽  
...  
Keyword(s):  
Lymph Node ◽  
Intrahepatic Cholangiocarcinoma ◽  
Major Hepatectomy ◽  
Lymph Node Status ◽  
National Cancer Database ◽  
Node Status

Expression of immunohistochemical markers in ampullary cancer (AC) and association with behavior.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e15184-e15184
Author(s):  
Milton Jose De Barros E. Silva ◽  
Adriana Regina G. Ribeiro ◽  
Maria D. Begnami ◽  
Felipe D'Almeida Costa ◽  
Wilson Luiz Costa ◽  
...  
Keyword(s):  
Lymph Node ◽  
Adjuvant Therapy ◽  
Positive Lymph Node ◽  
Lymph Node Status ◽  
R0 Resection ◽  
Histological Subtypes ◽  
Curative Intent ◽  
Immunohistochemical Markers ◽  
Node Status ◽  
Positive Lymph Node Status

e15184 Background: Curiously, the ampulla is formed by the union of two distinct types of mucosa: intestinal (GI) and pancreatobiliary(PB). Based on this fact, ACs could have different biologic behaviors. Methods: Between 1999 and 2012 we performed a retrospective analysis of patients with AC that underwent a pancreaticoduodenectomy (PD) with curative intent in our institution and the expressions of immunohistochemical markers related to GI origin (CK20 and CDX2) and to PB origin: (CK7 and MUC1) and its association with outcomes. Results: Twenty-seven patients underwent (PD), (M:F=15:12), median age was 62 (range33-83), 85.2% had R0 resection, 29.6% had positive lymph-nodes, 44.4% had perineural invasion, 22.2% had vascular invasion, 29.6% had lymphatic invasion, 59.2% had moderately differentiated tumors. AJCC stage pathologic grouping was: I=33.3%, II=37%, III= 29.6%; Median follow-up was 33.8 months. Relapse free survival was 43% in 3 years and overall survival was 53.7% in 5 years. The relapse rate was 59.2% and the majority of these relapses (69%) were distant metastasis without local relapse. Only positive lymph-node status (p=0,004, HR: 5.99) and R1 resection (R1: p=0.015, HR: 8.75) were independent prognostic factors for relapse on multivariate analysis. Among the patients, 21 were evaluated for the expression of immunohistochemical markers. Ten AC were classified into TGI type, 9 into PB type and 2 into unusual. An association between PB type and positive lymph node status (p=0.05) and more advanced stage (p=0.05) was found (Fisher’s exact test). There was no difference in relapse and survival between the histological subtypes, however, more PB patients had received adjuvant therapy. Conclusions: Histological subtypes of AC may have different behavior, but they are frequently neglected during decision of adjuvant therapy.

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