Tumor Burden Score Stratifies Prognosis of Patients With Intrahepatic Cholangiocarcinoma After Hepatic Resection: A Retrospective, Multi-Institutional Study.
Tumor Burden Score Stratifies Prognosis of Patients With Intrahepatic Cholangiocarcinoma After Hepatic Resection: A Retrospective, Multi-Institutional Study.
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肿瘤负荷评分对肝切除后肝内胆管癌患者的预后进行分层：一项回顾性、多机构研究
DOI：
10.3389/fonc.2022.829407
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发表时间：
2022
影响因子：
4.7
通讯作者：
Li D
中科院分区：
文献类型：
--
作者：
Li H;Liu R;Qiu H;Huang Y;Liu W;Li J;Wu H;Wang G;Li D
肿瘤负荷评分（TBS）对肝内胆管癌（ICC）根治性切除术患者预后意义尚未得到评估。本研究旨在探讨TBS及其与CA 19 -9（TBS和CA 19 -9联合，CTC分级）的协同作用对长期结局的影响。从多中心数据库中回顾性确定了2009年至2017年期间接受ICC根治性切除术的患者。分析总生存期（OS）和无复发生存期（RFS）与TBS、术前血清CA 19 -9和CTC分级的关系。我们的研究共纳入650例患者（509例在推导队列中，141例在验证队列中）。Kaplan-Meier曲线显示TBS和CA 19 -9水平是生存结局的强预测因子。TBS分级升高或CA 19 -9升高的患者与OS和RFS较差相关（均p < 0.001）。正如预期的那样，CTC分级在预测长期结局方面也表现良好。低TBS/低CA 19 -9（CTC 1级）患者与最佳OS和RFS相关，而高TBS/高CA 19 -9（CTC 3级）患者与最差结局相关。在验证队列中，TBS分级、术前CA 19 -9和CTC分级也对患者的预后进行了分层（各P < 0.001）。肿瘤形态学（肿瘤负荷）和肿瘤特异性生物标志物（血清CA 19 -9）在评估可切除ICC患者的预后时都很重要。血清CA 19 -9和TBS在预后评估中具有协同作用。CTC分级是判断ICC患者根治性切除术后预后的一个有前途的工具。
The prognostic significance of tumor burden score (TBS) on patients who underwent curative-intent resection of intrahepatic cholangiocarcinoma (ICC) has not been evaluated. The present study aimed to investigate the impact of TBS and its synergistic effect with CA19-9 (combination of TBS and CA19-9, CTC grade) on long-term outcomes. Patients who underwent radical resection of ICC between 2009 and 2017 were retrospectively identified from a multi-center database. The overall survival (OS) and recurrence-free survival (RFS) were examined in relation to TBS, serum preoperative CA19-9, and CTC grade. A total of 650 patients were included in our study (509 in the derivation cohort and 141 in the validation cohort). Kaplan–Meier curves showed that both TBS and CA19-9 levels were strong predictors of survival outcomes. Patients with elevated TBS grade or elevated CA19-9 were associated with worse OS and RFS (both p < 0.001). As expected, CTC grade also performed well in predicting long-term outcomes. Patients with low TBS/low CA19-9 (CTC grade 1) were associated with the best OS as well as RFS, while high TBS/high CA19-9 (CTC grade 3) correlated to the worst outcomes. In the validation cohort, TBS grade, preoperative CA19-9, and CTC grade also stratified prognosis among patients (p < 0.001 for each). Both tumor morphology (tumor burden) and tumor-specific biomarker (serum CA19-9) were important when evaluating prognosis of patients with resectable ICC. Serum CA19-9 and TBS showed a synergistic effect on prognostic evaluation. CTC grade was a promising tool in stratifying prognosis of ICC patients after curative resection.
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影响因子：
9
作者：
Tsilimigras, Diamantis, I;Mehta, Rittal;Pawlik, Timothy M.
通讯作者：
Pawlik, Timothy M.
影响因子：
29.4
作者：
Ilyas SI;Gores GJ
通讯作者：
Gores GJ
影响因子：
3.2
作者：
Nathan, Hari;Pawlik, Timothy M.;Schulick, Richard D.
通讯作者：
Schulick, Richard D.
影响因子：
2
作者：
Lee T;Teng TZJ;Shelat VG
通讯作者：
Shelat VG
胆管癌：当前的知识和新发展。
影响因子：
3.4
作者：
Blechacz B
通讯作者：
Blechacz B