Adjuvant chemotherapy combined with immunotherapy in patients with cholangiocarcinoma after radical resection.
Adjuvant chemotherapy combined with immunotherapy in patients with cholangiocarcinoma after radical resection.
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胆管癌的恶性是非常明显的，即使在标准化疗的情况下，它也表现出复发和转移的倾向。辅助化疗联合免疫治疗在胆管癌切除患者中的疗效有待证实。研究了2015年至2020年间在中山大学癌症中心接受治疗的101例胆管癌患者的数据。倾向评分匹配后，辅助化疗与免疫治疗联合组（AC + IM组）与单独辅助化疗组（AC组）患者基线特征差异无统计学意义（p < 0.05）。与AC组相比，AC + IM组在无复发生存（RFS）方面有统计学意义的改善（p = 0.032）。同样，与AC组相比，AC + IM组表现出明显优于AC组的总生存期（OS）结果（p = 0.044）。多因素Cox分析显示，神经周围浸润（p = 0.041）、淋巴结转移（p = 0.006）和术后免疫治疗（p = 0.008）是影响患者OS的独立预后因素。在神经周围侵袭患者队列中，AC + IM组的OS较AC组有显著改善（p = 0.0077）。同样，在淋巴结转移的患者亚群中，AC + IM组的OS结果明显优于AC组（p = 0.023）。术后辅助化疗联合免疫治疗可延长胆管癌根治后患者的RFS和OS。
The malignancy of cholangiocarcinoma is highly pronounced, and it exhibits a propensity for recurrence and metastasis even in the presence of standard chemotherapy. The efficacy of adjuvant chemotherapy combined with immunotherapy in patients with resected cholangiocarcinoma needs to be substantiated. Data from 101 patients with cholangiocarcinoma treated at the Sun Yat‐sen University Cancer Center between 2015 and 2020 were studied. After propensity score matching, there were no significant differences in baseline characteristics between patients in the combined adjuvant chemotherapy and immunotherapy group (AC + IM group) and the adjuvant chemotherapy alone group (AC group) (all p > 0.05). The AC + IM group demonstrated a statistically significant improvement in relapse‐free survival (RFS) compared to the AC group (p = 0.032). Likewise, the AC + IM group exhibited a significantly superior overall survival (OS) outcome when compared to the AC group (p = 0.044). Multivariate Cox analysis unveiled perineural invasion (p = 0.041), lymph node metastasis (p = 0.006), and postoperative immunotherapy (p = 0.008) as independent prognostic factors exerting a significant impact on the OS of patients. In the cohort of patients with perineural invasion, the AC + IM group exhibited significantly improved OS compared to the AC group (p = 0.0077). Similarly, within the subset of patients with lymph node metastasis, the AC + IM group exhibited a significantly superior OS outcome when compared to the AC group (p = 0.023). Combining postoperative adjuvant chemotherapy with immunotherapy extends the RFS and OS of patients with cholangiocarcinoma following radical resection.
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