Treatment outcomes and prognostic factors of intrahepatic cholangiocarcinoma.
Treatment outcomes and prognostic factors of intrahepatic cholangiocarcinoma.
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DOI：
10.3892/or.2013.2290
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发表时间：
2013-04
期刊：
影响因子：
4.2
通讯作者：
Cabrera R
中科院分区：
文献类型：
--
作者：
Dhanasekaran R;Hemming AW;Zendejas I;George T;Nelson DR;Soldevila-Pico C;Firpi RJ;Morelli G;Clark V;Cabrera R
本研究的目的是确定周围型肝内胆管细胞癌（ICC）患者的治疗结果和生存预后因素。对2000年至2009年在一家机构诊断为ICC的患者进行了回顾性病历审查。我们共确定了105例ICC患者。其中，63.8%的患者年龄大于60岁，50.5%为男性，88.6%为白人。通过术前成像，大约一半的患者（50.5%）是手术候选人并接受了切除。另一半患者（49.5%）不可切除。不可切除组接受放化疗（53%）和经动脉化疗栓塞（7.7%）作为姑息治疗，而23.0%的患者（12/52）仅接受最佳支持治疗。整个队列的中位生存率为16.1个月（13.1-19.2），根治性切除组为27.6个月（17.7-37.6），姑息性放化疗组为12.9个月（6.5-19.2），最佳支持治疗组为4.9个月（0.4-9.6）（P<0.001）。多变量分析的独立预测因素是诊断和治疗时的晚期。在那些接受切除术的患者中，晚期AJCC分期和微血管浸润的存在也是生存率低的独立预测因素。我们的结论是手术提供了最有益的治疗选择和结果，强调了可切除性作为主要预后因素的重要性。目前的研究还表明，在辅助治疗中使用放化疗未能提高生存率，但在不可切除的ICC患者中使用姑息治疗比最佳支持治疗具有一定的生存优势。影响预后的主要因素是病理分期和微血管侵犯。
The aim of the present study was to determine the treatment outcome and prognostic factors for survival in patients with peripheral intrahepatic cholangiocarcinoma (ICC). A retrospective chart review was performed for patients diagnosed with ICC between 2000 and 2009 at a single institution. We identified a total of 105 patients with ICC. Among them, 63.8% were older than 60 years of age, 50.5% were male and 88.6% were Caucasian. By preoperative imaging approximately half of the patients (50.5%) were surgical candidates and underwent resection. The other half of the patients (49.5%) were unresectable. The unresectable group received chemoradiotherapy (53%) and transarterial chemoembolization (7.7%) as palliative treatments while 23.0% of the patients (12/52) received best supportive care alone. The median survival rates were 16.1 months (13.1–19.2) for the entire cohort, 27.6 months (17.7–37.6) for curative resection, 12.9 months (6.5–19.2) for palliative chemoradiotherapy and 4.9 months (0.4–9.6) for best supportive care (P<0.001). Independent predictors on multivariate analysis were advanced stage at diagnosis and treatment received. In those patients who underwent resection, advanced AJCC stage and presence of microvascular invasion were also independent predictors of poor survival. We concluded that surgery offers the most beneficial curative option and outcome, emphasizing the importance of resectability as a major prognostic factor. The present study also revealed that use of chemoradiotherapy in the adjuvant setting failed to improve survival but its palliative use in those patients with unresectable ICC offered a modest survival advantage over best supportive care. The overriding factors influencing outcome were stage and the presence of microvascular invasion on pathology.
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影响因子：
6.1
作者：
Li Shao-qiang;Liang Li-jian;Chen Dong
通讯作者：
Chen Dong
影响因子：
5.6
作者：
Torbenson, Michael;Yeh, Matthew M.;Abraham, Susan C.
通讯作者：
Abraham, Susan C.
DOI：
10.6004/jnccn.2009.0030
发表时间：
2009-04-01
影响因子：
13.4
作者：
Chang, Kwang-Yu;Chang, Jang-Yang;Yen, Yun
通讯作者：
Yen, Yun
影响因子：
25.7
作者：
Shaib, YH;Davila, JA;El-Serag, HB
通讯作者：
El-Serag, HB
影响因子：
12.6
作者：
Welzelt, Tania M.;Graubard, Barry I.;McGlynn, Katherine A.
通讯作者：
McGlynn, Katherine A.