Multicenter retrospective analysis of systemic chemotherapy for unresectable combined hepatocellular and cholangiocarcinoma.
Multicenter retrospective analysis of systemic chemotherapy for unresectable combined hepatocellular and cholangiocarcinoma.
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DOI：
10.1111/cas.13656
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发表时间：
2018-08
期刊：
影响因子：
5.7
通讯作者：
Furuse J
中科院分区：
文献类型：
--
作者：
Kobayashi S;Terashima T;Shiba S;Yoshida Y;Yamada I;Iwadou S;Horiguchi S;Takahashi H;Suzuki E;Moriguchi M;Tsuji K;Otsuka T;Asagi A;Kojima Y;Takada R;Morizane C;Mizuno N;Ikeda M;Ueno M;Furuse J
我们进行了一项多中心回顾性分析，以评估全身化疗对不可切除的联合肝细胞癌和胆管癌的疗效。我们招募了 36 名经病理证实、不可切除的肝细胞癌和胆管癌合并患者，并接受全身化疗。对数秩检验确定了每个预后因素的重要性。甲胎蛋白、癌胚抗原和碳水化合物抗原 19-9 水平分别在 58.3%、16.7% 和 38.9% 的患者中观察到升高。一线化疗包括含铂方案，包括吉西他滨/顺铂 (n = 12) 和氟尿嘧啶/顺铂 (n = 11)、索拉非尼 (n = 5) 和其他 (n = 8)。中位总生存期和无进展生存期分别为 8.9 个月和 2.8 个月，总缓解率为 5.6%。与负面结果相关的预后因素包括体能状态不佳、既往未进行原发肿瘤切除、Child-Pugh B 级以及癌胚抗原水平升高，单变量分析的风险比分别为 2.25、2.48、3.25 和 2.84。吉西他滨/顺铂、氟尿嘧啶/顺铂、索拉非尼和其他组的中位总生存时间分别为 11.9、10.2、3.5 和 8.1 个月。多变量分析显示，与含铂方案相比，索拉非尼单药治疗组患者的总生存率较差（HR：15.83 [95% CI：2.25‐111.43]，P = .006）。索拉非尼组的所有 7 名患者均出现疾病进展，其中 2 名患者接受二线治疗。总之，对于不可切除的混合性肝细胞癌和胆管癌，吉西他滨/顺铂等含铂方案比索拉非尼单药治疗具有更有利的结果。
We conducted a multicenter retrospective analysis to evaluate the efficacy of systemic chemotherapy for unresectable combined hepatocellular and cholangiocarcinoma. We enrolled 36 patients with pathologically proven, unresectable combined hepatocellular and cholangiocarcinoma treated with systemic chemotherapy. The log‐rank test determined the significance of each prognostic factor. Elevated alpha‐fetoprotein, carcinoembryonic antigen and carbohydrate antigen 19‐9 levels were observed in 58.3%, 16.7% and 38.9% of patients, respectively. First‐line chemotherapy included platinum‐containing regimens consisting of gemcitabine/cisplatin (n = 12) and fluorouracil/cisplatin (n = 11), sorafenib (n = 5) and others (n = 8). The median overall and progression‐free survival times were 8.9 and 2.8 months, respectively, with an overall response rate of 5.6%. Prognostic factors associated with negative outcomes included poor performance status, no prior primary tumor resection, a Child‐Pugh class of B, and elevated carcinoembryonic antigen levels with a hazard ratio of 2.25, 2.48, 3.25 and 2.84 by univariate analysis, respectively. The median overall survival times of the gemcitabine/cisplatin, fluorouracil/cisplatin, sorafenib and other groups were 11.9, 10.2, 3.5 and 8.1 months, respectively. Multivariate analysis revealed that the overall survival of patients within the sorafenib monotherapy group was poor compared with platinum‐containing regimens (HR: 15.83 [95% CI: 2.25‐111.43], P = .006). All 7 patients in the sorafenib group had progressive disease, including 2 patients with second‐line therapy. In conclusion, the platinum‐containing regimens such as gemcitabine/cisplatin were associated with more favorable outcomes than sorafenib monotherapy for unresectable combined hepatocellular and cholangiocarcinoma.
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影响因子：
8.4
作者：
Eisenhauer, E. A.;Therasse, P.;Verweij, J.
通讯作者：
Verweij, J.
影响因子：
4.6
作者：
Kim GM;Jeung HC;Kim D;Kim JH;Yoon SH;Jung ES;Shin SJ
通讯作者：
Shin SJ
影响因子：
3.2
作者：
Tang, Di;Nagano, Hiroaki;Monden, Morito
通讯作者：
Monden, Morito
影响因子：
3.3
作者：
Aishima, S;Kuroda, Y;Tsuneyoshi, M
通讯作者：
Tsuneyoshi, M
DOI：
10.1046/j.1440-1746.2002.02734.x
发表时间：
2002-04-01
影响因子：
4.1
作者：
Okuda, K
通讯作者：
Okuda, K