Perineural invasion confers poorer clinical outcomes in patients with T1/T2 intrahepatic cholangiocarcinoma: a single center, retrospective cohort study.
Perineural invasion confers poorer clinical outcomes in patients with T1/T2 intrahepatic cholangiocarcinoma: a single center, retrospective cohort study.
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DOI：
10.21037/jgo-23-950
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发表时间：
2023-12-31
影响因子：
2.1
通讯作者：
Liu, Hui
中科院分区：
文献类型：
--
作者：
Zou, Minghao;Sheng, Jie;Ruan, Minghao;Zhou, Wenxuan;Ye, Feiyang;Yang, Gaowei;Qian, Ye;Wang, Jian;Wang, Ruoyu;Liu, Suiyi;Liu, Hui
肝内胆管细胞癌（ICC）提出了一个重大的临床挑战，需要彻底了解有效的病人管理的预后指标。尽管有报告表明神经周围浸润（PNI）对早期ICC患者预后的影响，但缺乏专门针对该亚组的综合研究。本研究旨在调查PNI对早期ICC患者生存结局的影响，旨在提高美国癌症联合委员会（AJCC）T分类的预后价值。2011年至2015年在东部肝胆外科医院接受治愈性切除术（R 0）的268例早期（T1-T2 N 0 M0）ICC患者队列入组本研究。采用Lasso和考克斯回归分析探讨临床和预后数据的差异。Kaplan-Meier曲线分析PNI与T分类联合应用的临床意义。在268例患者中，24.6%出现PNI。PNI患者的无复发生存期（RFS）[中位RFS：16个月（四分位距，9.5-19个月）]和总生存期（OS）[中位OS：16.53个月（四分位距，10-25个月）]较短。在T1和T2期患者中，PNI是RFS和OS的独立危险因素（均P<0.05），而肿瘤大小仅是OS的独立危险因素（P=0.004）。PNI与ICC患者的所有预后指标相关，包括性别、黄疸、胆管炎、B型肝炎病毒（HBV）感染、癌抗原199（CA 199）、术前血清白蛋白和术前血小板计数（均P<0.05）。T2期无PNI患者与T1期有PNI患者的RFS（P=0.270）和OS（P=0.360）差异无统计学意义。本研究强调PNI是早期ICC的一个强有力的预后因素，强调将PNI纳入AJCC T类别以进行精确风险分层的必要性。在临床上，了解PNI对生存结局的影响可以指导早期ICC患者的定制治疗策略。
Intrahepatic cholangiocarcinoma (ICC) poses a significant clinical challenge, demanding a thorough understanding of prognostic indicators for effective patient management. Despite reports suggesting the impact of perineural invasion (PNI) on the prognosis of early-stage ICC patients, there has been a dearth of comprehensive research specifically targeting this subgroup. This study seeks to investigate the influence of PNI on survival outcomes in early-stage ICC patients and aims to enhance the prognostic value of the American Joint Committee on Cancer (AJCC) T category. A cohort of 268 early-stage (T1-T2N0M0) ICC patients, who underwent curative-intent resection (R0) between 2011 and 2015 at the Eastern Hepatobiliary Surgery Hospital, were enrolled in this study. Lasso and Cox regression analyses were employed to explore differences in clinical and prognostic data. Kaplan-Meier curves were generated to illustrate the clinical significance of the combination of PNI and T category. Among the 268 patients, 24.6% exhibited PNI. Patients with PNI demonstrated shorter recurrence-free survival (RFS) [median RFS: 16 months (interquartile range, 9.5–19 months)] and overall survival (OS) [median OS: 16.53 months (interquartile range, 10–25 months)]. PNI emerged as an independent risk factor for both RFS and OS in T1- and T2-stage patients (all P<0.05), whereas tumor size was only an independent risk factor for OS (P=0.004). PNI was associated with all prognostic markers for ICC patients, including gender, jaundice, cholangitis, hepatitis B virus (HBV) infection, cancer antigen 199 (CA199), preoperative serum albumin, and preoperative platelet count (all P<0.05). However, there was no significant difference in RFS (P=0.270) and OS (P=0.360) between T2 patients without PNI and T1 patients with PNI. This study underscores PNI as a robust prognostic factor in early-stage ICC, emphasizing the necessity of incorporating PNI into the AJCC T category for precise risk stratification. Clinically, understanding the impact of PNI on survival outcomes can guide tailored treatment strategies for early ICC patients.
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影响因子：
4
作者：
通讯作者：
--
影响因子：
0.9
作者：
通讯作者：
--
DOI：
10.1634/theoncologist.2015-0446
发表时间：
2016-05
期刊：
The oncologist
影响因子：
--
作者：
Saha SK;Zhu AX;Fuchs CS;Brooks GA
通讯作者：
Brooks GA
影响因子：
3.2
作者：
Hwang, Shin;Lee, Young-Joo;Lee, Sung-Gyu
通讯作者：
Lee, Sung-Gyu
肝内胆管癌微血管侵犯患者术后辅助经动脉化疗栓塞：倾向评分分析。
影响因子：
2.1
作者：
Cheng, Zhangjun;Lei, Zhengqing;Shen, Feng
通讯作者：
Shen, Feng