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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...
Autores principales: | , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2018
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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. |
format | Online Article Text |
id | pubmed-6113439 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
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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