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Benefit of adjuvant radiotherapy following narrow-margin hepatectomy in patients with intrahepatic cholangiocarcinoma that adhere to major vessels

PURPOSE: To evaluate the role of adjuvant radiotherapy after narrow-margin (<1.0 cm) resection in patients with intrahepatic cholangiocarcinoma (ICC) adherent to major vessels. PATIENTS AND METHODS: This retrospective study included 70 ICC patients. Forty-nine patients received narrow-margin (<...

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Autores principales: Zheng, Xuan, Chen, Bo, Wu, Jian-Xiong, Jia, Angela Y, Rong, Wei-Qi, Wang, Li-Ming, Wu, Fan, Zhao, Yu-Ting, Li, Ye-Xiong, Wang, Wei-Hu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6165777/
https://www.ncbi.nlm.nih.gov/pubmed/30310318
http://dx.doi.org/10.2147/CMAR.S172940
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author Zheng, Xuan
Chen, Bo
Wu, Jian-Xiong
Jia, Angela Y
Rong, Wei-Qi
Wang, Li-Ming
Wu, Fan
Zhao, Yu-Ting
Li, Ye-Xiong
Wang, Wei-Hu
author_facet Zheng, Xuan
Chen, Bo
Wu, Jian-Xiong
Jia, Angela Y
Rong, Wei-Qi
Wang, Li-Ming
Wu, Fan
Zhao, Yu-Ting
Li, Ye-Xiong
Wang, Wei-Hu
author_sort Zheng, Xuan
collection PubMed
description PURPOSE: To evaluate the role of adjuvant radiotherapy after narrow-margin (<1.0 cm) resection in patients with intrahepatic cholangiocarcinoma (ICC) adherent to major vessels. PATIENTS AND METHODS: This retrospective study included 70 ICC patients. Forty-nine patients received narrow-margin (<1.0 cm) hepatectomy and 21 patients underwent wide-margin (≥1.0 cm) hepatectomy (Group C). Twenty-six of 49 were treated with postoperative radiotherapy (Group A), while the remaining 23 did not receive radiotherapy (Group B). Clinical outcomes were compared in the 3 groups. Toxicities of radiotherapy were evaluated. RESULTS: With a median follow-up time of 42 months, the 3-year overall survival (OS) and disease-free survival rates were 55% and 44% for Group A, 20% and 10% for Group B, and 65% and 33% for Group C, respectively. The OS and disease-free survival in Groups A and C were comparable and improved compared to Group B (Group A vs B, P=0.011 and P=0.031; and Group C vs B, P=0.031 and P=0.105). Multivariate analysis showed that receiving narrow-margin resection only (adjusted hazard ratio: 3.73; 95% CI: 1.36–10.25; P=0.001) was a significant poor prognostic risk factor of OS. Group B experienced more intrahepatic recurrence and extrahepatic recurrence than Groups A and C. For Groups A and B, the 3-year intrahepatic recurrence rates were 36% vs 67% (P=0.133) and extrahepatic recurrence rates were 43% vs 65% (P=0.007). Only 2 patients in Group A suffered from grade 3 toxicities. No patient developed classic or nonclassic radiation-induced liver disease. CONCLUSION: Postoperative radiotherapy following narrow-margin hepatectomy seems to be efficacious and well-tolerated in patients with ICC adjacent to major vessels.
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spelling pubmed-61657772018-10-11 Benefit of adjuvant radiotherapy following narrow-margin hepatectomy in patients with intrahepatic cholangiocarcinoma that adhere to major vessels Zheng, Xuan Chen, Bo Wu, Jian-Xiong Jia, Angela Y Rong, Wei-Qi Wang, Li-Ming Wu, Fan Zhao, Yu-Ting Li, Ye-Xiong Wang, Wei-Hu Cancer Manag Res Original Research PURPOSE: To evaluate the role of adjuvant radiotherapy after narrow-margin (<1.0 cm) resection in patients with intrahepatic cholangiocarcinoma (ICC) adherent to major vessels. PATIENTS AND METHODS: This retrospective study included 70 ICC patients. Forty-nine patients received narrow-margin (<1.0 cm) hepatectomy and 21 patients underwent wide-margin (≥1.0 cm) hepatectomy (Group C). Twenty-six of 49 were treated with postoperative radiotherapy (Group A), while the remaining 23 did not receive radiotherapy (Group B). Clinical outcomes were compared in the 3 groups. Toxicities of radiotherapy were evaluated. RESULTS: With a median follow-up time of 42 months, the 3-year overall survival (OS) and disease-free survival rates were 55% and 44% for Group A, 20% and 10% for Group B, and 65% and 33% for Group C, respectively. The OS and disease-free survival in Groups A and C were comparable and improved compared to Group B (Group A vs B, P=0.011 and P=0.031; and Group C vs B, P=0.031 and P=0.105). Multivariate analysis showed that receiving narrow-margin resection only (adjusted hazard ratio: 3.73; 95% CI: 1.36–10.25; P=0.001) was a significant poor prognostic risk factor of OS. Group B experienced more intrahepatic recurrence and extrahepatic recurrence than Groups A and C. For Groups A and B, the 3-year intrahepatic recurrence rates were 36% vs 67% (P=0.133) and extrahepatic recurrence rates were 43% vs 65% (P=0.007). Only 2 patients in Group A suffered from grade 3 toxicities. No patient developed classic or nonclassic radiation-induced liver disease. CONCLUSION: Postoperative radiotherapy following narrow-margin hepatectomy seems to be efficacious and well-tolerated in patients with ICC adjacent to major vessels. Dove Medical Press 2018-09-26 /pmc/articles/PMC6165777/ /pubmed/30310318 http://dx.doi.org/10.2147/CMAR.S172940 Text en © 2018 Zheng et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Original Research
Zheng, Xuan
Chen, Bo
Wu, Jian-Xiong
Jia, Angela Y
Rong, Wei-Qi
Wang, Li-Ming
Wu, Fan
Zhao, Yu-Ting
Li, Ye-Xiong
Wang, Wei-Hu
Benefit of adjuvant radiotherapy following narrow-margin hepatectomy in patients with intrahepatic cholangiocarcinoma that adhere to major vessels
title Benefit of adjuvant radiotherapy following narrow-margin hepatectomy in patients with intrahepatic cholangiocarcinoma that adhere to major vessels
title_full Benefit of adjuvant radiotherapy following narrow-margin hepatectomy in patients with intrahepatic cholangiocarcinoma that adhere to major vessels
title_fullStr Benefit of adjuvant radiotherapy following narrow-margin hepatectomy in patients with intrahepatic cholangiocarcinoma that adhere to major vessels
title_full_unstemmed Benefit of adjuvant radiotherapy following narrow-margin hepatectomy in patients with intrahepatic cholangiocarcinoma that adhere to major vessels
title_short Benefit of adjuvant radiotherapy following narrow-margin hepatectomy in patients with intrahepatic cholangiocarcinoma that adhere to major vessels
title_sort benefit of adjuvant radiotherapy following narrow-margin hepatectomy in patients with intrahepatic cholangiocarcinoma that adhere to major vessels
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6165777/
https://www.ncbi.nlm.nih.gov/pubmed/30310318
http://dx.doi.org/10.2147/CMAR.S172940
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