Real-world experience of postoperative adjuvant chemoimmunotherapy in patients with perihilar cholangiocarcinoma at high risk of recurrence
Real-world experience of postoperative adjuvant chemoimmunotherapy in patients with perihilar cholangiocarcinoma at high risk of recurrence
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DOI：
10.1007/s00262-022-03362-7
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发表时间：
2023-01-17
影响因子：
5.8
通讯作者：
Liu, Chao
中科院分区：
文献类型：
--
作者：
Liu, Qin-qin;Shi, Xiang-de;Liu, Chao
BackgroundThis study aims to assess after adjuvant chemoimmunotherapy could lead to better clinical outcomes for high-risk pCCA.MethodsIn the cohort study，我们回顾性分析了2018年1月至2021年12月在中山纪念医院接受根治性pCCA手术切除的患者。其中，20例患者接受了辅助免疫化疗，28例患者接受了辅助化疗，33例患者接受了单纯手术治疗。肿瘤的结果和药物相关的不良事件进行了evaluated.ResultsThe 2年的总生存率（OS）的患者与辅助化疗免疫治疗，辅助化疗，手术单独治疗分别为80.0%，49.4%和22.6%，分别。单因素和多因素考克斯分析显示，治疗方案和TNM分期与不良OS有关，辅助化疗免疫治疗导致OS比辅助化疗或单纯手术增加[风险比（HR）= 3.253; 95%可信区间（CI）1.072-9.870; P = 0.037]（HR = 7.560; 95% CI 2.508-22.785; P < 0.001）。辅助免疫化疗组的中位无复发生存期为22.0个月，辅助化疗组为17.0个月，单纯手术组为13.2个月（P = 0.177）;这些差异无显著性。化疗免疫组与更频繁的血液学副作用比化疗组，但差异无统计学意义。ConclusionPostoperative adjuvant chemoimmunotherapy for removed pCCA patients showed improved OS相比，辅助化疗或单纯手术，进一步的前瞻性随机对照试验是必要的，以验证这些结果。
BackgroundThis study aimed to assess whether postoperative adjuvant chemoimmunotherapy could lead to better clinical outcomes for high-risk patients with perihilar cholangiocarcinoma (pCCA).MethodsIn the cohort study, we retrospectively reviewed patients who received surgical resection for pCCA with curative intent from January 2018 to December 2021 at the Sun Yat-sen Memorial Hospital.The patients at high risk for relapse were further analyzed. Among them, 20 patients received adjuvant chemoimmunotherapy, 28 patients received adjuvant chemotherapy, and 33 patients received surgery alone. The oncological outcomes and drug-associated adverse events were evaluated.ResultsThe 2-year overall survival (OS) rates in patients treated with adjuvant chemoimmunotherapy, adjuvant chemotherapy, and surgery alone were 80.0%, 49.4% and 22.6%, respectively. Univariable and multivariable Cox analyses showed that the treatment regimen and TNM stage were associated with adverse OS. Adjuvant chemoimmunotherapy led to an increase in OS compared with adjuvant chemotherapy [hazard ratio (HR) = 3.253; 95% confidence interval (CI) 1.072-9.870; P = 0.037] or surgery alone (HR = 7.560; 95% CI 2.508-22.785; P < 0.001). The median recurrence-free survival was 22.0 months for the adjuvant chemoimmunotherapy group, 17.0 months for the adjuvant chemotherapy group, and 13.2 months for the surgery alone group (P = 0.177); these differences were not significant. The chemoimmunotherapy group was associated with more frequent hematological side effects than the chemotherapy group, but the difference was not statistically significant.ConclusionPostoperative adjuvant chemoimmunotherapy for resected pCCA patients showed improved OS compared with adjuvant chemotherapy or surgery alone, and further prospectively randomized controlled trials are necessary to validate these results.