Multimodality therapy for locoregional extrahepatic cholangiocarcinoma: a population-based analysis.
Multimodality therapy for locoregional extrahepatic cholangiocarcinoma: a population-based analysis.
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DOI：
10.1002/cncr.24572
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发表时间：
2009-11-15
期刊：
影响因子：
6.2
通讯作者：
Thomas, Charles R., Jr.
中科院分区：
文献类型：
--
作者：
Fuller, Clifton D.;Wang, Samuel J.;Choi, Mehee;Czito, Brian G.;Cornell, John;Welzel, Tania M.;McGlynn, Katherine A.;Luh, Join Y.;Thomas, Charles R., Jr.
虽然手术切除是治疗肝外胆管癌（EHCC）的主要方法，但大多数患者都是晚期疾病。部分由于数量稀少，放射治疗（RT）对EHCC的最佳作用及其相对益处是一个有争议的领域。该系列的具体目的是使用基于人群的数据集来估计接受手术和辅助RT的EHCC患者的生存率。数据提取自选定EHCC病例的监测、流行病学和最终结果（SEER）有限使用数据集。实施对数正态多变量生存分析以基于手术干预程度和RT估计治疗组的患者的生存。接受全/根治性切除+RT的患者的参数估计的中位生存期为26个月，仅全/根治性切除为25个月，次全/减积切除+RT为25个月，次全/减积切除为21个月，仅RT为12个月，参数多变量分析显示年龄、AJCC分期、分级和手术/放疗方案是生存率的统计学显著协变量。单独手术和辅助放疗队列显示出与未治疗相比生存率提高的证据;相比之下，单独放疗与生存率降低相关。在随后的时间点，未观察到辅助队列中生存期的早期改善。使用SEER数据估计生存率提示局部EHCC辅助放疗的早期生存优势。虽然需要未来的前瞻性系列来证实这些观察结果，但SEER数据代表了国内最大的基于人群的EHCC队列，并可能为未来的研究提供有用的基线生存估计。
While surgical resection is the mainstay of treatment for extrahepatic cholangiocarcinoma (EHCC), most patients present with advanced disease. Owing in part to numerical rarity, the optimum role of radiotherapy (RT) for EHCC, as well as its relative benefit is an area of debate. The specific aim of this series is to estimate survival for EHCC patients receiving surgery and adjuvant RT using a robust population based dataset. Data was extracted from the Surveillance, Epidemiology, and End Results (SEER) limited-use dataset for selected EHCC cases. Lognormal multivariate survival analysis was implemented to estimate survival for patients for treatment cohorts based on extent of surgical intervention and RT. Parametric estimated median survival for patients receiving total/radical resection+RT was 26 months, 25 months for total/radical resection alone, 25 months for subtotal/debulking resection+RT, 21 months for subtotal/debulking resection, 12 months for RT alone, and 9 months for those not receiving surgery or RT. Parametric multivariate analysis revealed age, AJCC Stage, grade, and surgical/radiation regimen as statistically significant covariates with survival. Surgery-alone and adjuvant radiotherapy cohorts showed evidence of improved survival compared to no treatment; comparatively, radiation alone was associated with survival decrement. Early improvement in survival in adjuvant cohorts was not observed at later time-points. Survival estimates using SEER data suggest an early survival advantage for adjuvant radiotherapy for locoregional EHCC. While future prospective series are needed to confirm these observations, SEER data represents the largest domestic population-based EHCC cohort, and may provide useful baseline survival estimates for future studies.
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DOI：
10.1016/0360-3016(87)90006-x
发表时间：
1987-03-01
影响因子：
7
作者：
FIELDS, JN;EMAMI, B
通讯作者：
EMAMI, B
影响因子：
6.2
作者：
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通讯作者：
Fong, YM
DOI：
10.1016/j.ijrobp.2006.05.061
发表时间：
2006-11-01
影响因子：
7
作者：
Ben-David, Merav A.;Griffith, Kent A.;Ben-Josef, Edgar
通讯作者：
Ben-Josef, Edgar
DOI：
10.1016/j.ijrobp.2003.12.030
发表时间：
2004-07-15
影响因子：
7
作者：
Fuss, M;Salter, BJ;Thomas, CR
通讯作者：
Thomas, CR
影响因子：
3.7
作者：
KAPLAN, EL;MEIER, P
通讯作者：
MEIER, P