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Multicenter retrospective analysis of systemic chemotherapy for unresectable combined hepatocellular and cholangiocarcinoma

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 c...

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Autores principales: Kobayashi, Satoshi, Terashima, Takeshi, Shiba, Satoshi, Yoshida, Yukio, Yamada, Ikuhiro, Iwadou, Shouta, Horiguchi, Shigeru, Takahashi, Hideaki, Suzuki, Eiichiro, Moriguchi, Michihisa, Tsuji, Kunihiro, Otsuka, Taiga, Asagi, Akinori, Kojima, Yasushi, Takada, Ryoji, Morizane, Chigusa, Mizuno, Nobumasa, Ikeda, Masafumi, Ueno, Makoto, Furuse, Junji
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6113439/
https://www.ncbi.nlm.nih.gov/pubmed/29856900
http://dx.doi.org/10.1111/cas.13656
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author Kobayashi, Satoshi
Terashima, Takeshi
Shiba, Satoshi
Yoshida, Yukio
Yamada, Ikuhiro
Iwadou, Shouta
Horiguchi, Shigeru
Takahashi, Hideaki
Suzuki, Eiichiro
Moriguchi, Michihisa
Tsuji, Kunihiro
Otsuka, Taiga
Asagi, Akinori
Kojima, Yasushi
Takada, Ryoji
Morizane, Chigusa
Mizuno, Nobumasa
Ikeda, Masafumi
Ueno, Makoto
Furuse, Junji
author_facet Kobayashi, Satoshi
Terashima, Takeshi
Shiba, Satoshi
Yoshida, Yukio
Yamada, Ikuhiro
Iwadou, Shouta
Horiguchi, Shigeru
Takahashi, Hideaki
Suzuki, Eiichiro
Moriguchi, Michihisa
Tsuji, Kunihiro
Otsuka, Taiga
Asagi, Akinori
Kojima, Yasushi
Takada, Ryoji
Morizane, Chigusa
Mizuno, Nobumasa
Ikeda, Masafumi
Ueno, Makoto
Furuse, Junji
author_sort Kobayashi, Satoshi
collection PubMed
description 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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spelling pubmed-61134392018-09-04 Multicenter retrospective analysis of systemic chemotherapy for unresectable combined hepatocellular and cholangiocarcinoma Kobayashi, Satoshi Terashima, Takeshi Shiba, Satoshi Yoshida, Yukio Yamada, Ikuhiro Iwadou, Shouta Horiguchi, Shigeru Takahashi, Hideaki Suzuki, Eiichiro Moriguchi, Michihisa Tsuji, Kunihiro Otsuka, Taiga Asagi, Akinori Kojima, Yasushi Takada, Ryoji Morizane, Chigusa Mizuno, Nobumasa Ikeda, Masafumi Ueno, Makoto Furuse, Junji Cancer Sci Original Articles 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. John Wiley and Sons Inc. 2018-06-27 2018-08 /pmc/articles/PMC6113439/ /pubmed/29856900 http://dx.doi.org/10.1111/cas.13656 Text en © 2018 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Articles
Kobayashi, Satoshi
Terashima, Takeshi
Shiba, Satoshi
Yoshida, Yukio
Yamada, Ikuhiro
Iwadou, Shouta
Horiguchi, Shigeru
Takahashi, Hideaki
Suzuki, Eiichiro
Moriguchi, Michihisa
Tsuji, Kunihiro
Otsuka, Taiga
Asagi, Akinori
Kojima, Yasushi
Takada, Ryoji
Morizane, Chigusa
Mizuno, Nobumasa
Ikeda, Masafumi
Ueno, Makoto
Furuse, Junji
Multicenter retrospective analysis of systemic chemotherapy for unresectable combined hepatocellular and cholangiocarcinoma
title Multicenter retrospective analysis of systemic chemotherapy for unresectable combined hepatocellular and cholangiocarcinoma
title_full Multicenter retrospective analysis of systemic chemotherapy for unresectable combined hepatocellular and cholangiocarcinoma
title_fullStr Multicenter retrospective analysis of systemic chemotherapy for unresectable combined hepatocellular and cholangiocarcinoma
title_full_unstemmed Multicenter retrospective analysis of systemic chemotherapy for unresectable combined hepatocellular and cholangiocarcinoma
title_short Multicenter retrospective analysis of systemic chemotherapy for unresectable combined hepatocellular and cholangiocarcinoma
title_sort multicenter retrospective analysis of systemic chemotherapy for unresectable combined hepatocellular and cholangiocarcinoma
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6113439/
https://www.ncbi.nlm.nih.gov/pubmed/29856900
http://dx.doi.org/10.1111/cas.13656
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