The Addition of Transarterial Chemoembolization to Palliative Chemotherapy Extends Survival in Intrahepatic Cholangiocarcinoma
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. Baseline Characteristics
3.2. Treatment
3.3. Survival
3.4. Locoregional Therapy
3.5. Case Study
4. Discussion
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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pCTX + TACE (n = 14) | n † | pCTX (n = 59) | n † | p Value | |
---|---|---|---|---|---|
Age at initial diagnosis—years | |||||
median (range) | 61.3 (36.7–79.3) | 14 | 66.8 (28.8–83.1) | 59 | 0.073 |
Age at first-line pCTX—years | |||||
median (range) | 61.7 (38.3–79.5) | 14 | 67.7 (29.3–83.4) | 59 | 0.076 |
Gender—no. (%) | |||||
female | 8 (57.1) | 14 | 29 (49.2) | 59 | 0.591 |
male | 6 (42.9) | 30 (50.8) | |||
BMI—kg/m2 | |||||
median (range) | 26.4 (17.3–36.4) | 13 | 26.0 (15.8–35.3) | 53 | 0.332 |
ECOG PS at first-line pCTX—no. (%) | |||||
0 | 13 (92.9) | 14 | 24 (49.0) | 49 | 0.028 |
1 | 1 (7.1) | 19 (38.8) | |||
2 | 0 (0.0) | 5 (8.5) | |||
3 | 0 (0.0) | 1 (2.0) | |||
Initial resectability—no. (%) | |||||
yes | 4 (28.6) | 14 | 24 (40.7) | 59 | 0.402 |
Recurrence resectability—no. (%) | |||||
yes | 0 (0.0) | 4 | 2 (8.3) | 24 | 1.000 |
UICC stage—no. (%) | |||||
1 | 0 (0.0) | 14 | 7 (13.7) | 51 | 0.003 |
2 | 10 (71.4) | 10 (19.6) | |||
3 | 0 (0.0) | 2 (3.9) | |||
4 | 4 (28.6) | 32 (62.7) | |||
Grading—no. (%) | |||||
1 | 0 (0.0) | 7 | 1 (2.8) | 36 | 0.740 |
2 | 5 (71.4) | 21 (58.3) | |||
3 | 2 (28.6) | 14 (38.9) | |||
CA19-9 (U/mL) | |||||
median (range) | 33 (4–4271) | 14 | 66 (2–696664) | 44 | 0.502 |
CEA (ng/mL) | |||||
median (range) | 1.1 (0.2–39.0) | 13 | 1.7 (0.5–4328.1) | 34 | 0.517 |
Albumin (g/L) | |||||
median (range) | 37.5 (28.0–42.0) | 14 | 31.0 (19.0–42.0) | 34 | <0.001 |
Bilirubin (mg/dL) | |||||
median (range) | 0.7 (0.2–1.3) | 14 | 0.9 (0.3–7.7) | 49 | 0.007 |
pCTX + TACE (n = 14) | n † | pCTX (n = 59) | n † | p Value | |
---|---|---|---|---|---|
Vital status—no. (%) | |||||
alive | 3 (21.4) | 14 | 7 (11.9) | 59 | 0.392 |
dead | 11 (78.6) | 52 (88.1) | |||
alive-receiving pCTX treatment | 1 (7.1) | 14 | 3 (5.1) | 59 | 1.000 |
Adjuvant CTX—no. (%) | |||||
yes | 0 (0.0) | 14 | 8 (13.6) | 59 | 0.340 |
pCTX lines—no. (%) | |||||
1 | 4 (28.6) | 14 | 23 (39.0) | 59 | 0.380 |
2 | 4 (28.6) | 24 (40.7) | |||
3 | 4 (28.6) | 7 (11.9) | |||
4 | 2 (14.3) | 4 (6.8) | |||
5 | 0 (0.0) | 1 (1.7) | |||
median (range) | 2 (1–4) | 2 (1–5) | |||
First-line pCTX—no. (%) | |||||
Gemcitabine | 1 (7.1) | 14 | 13 (22.0) | 59 | 0.672 |
GemCis/GemOx | 9 (64.3) | 25 (42.4) | |||
FOLFOX/CAPOX | 1 (7.1) | 7 (11.9) | |||
FOLFIRINOX | 1 (7.1) | 5 (8.5) | |||
Other | 2 (14.3) | 9 (15.3) | |||
Cycles (median (range)) | 6 (2–18) | 14 | 4 (1–27) | 59 | 0.200 |
Second-line pCTX—no. (%) | |||||
Gemcitabine | 2 (20.0) | 10 | 7 (19.4) | 36 | 0.563 |
GemCis/GemOx | 2 (20.0) | 8 (22.2) | |||
FOLFOX/CAPOX | 1 (10.0) | 11 (30.6) | |||
FOLFIRINOX | 0 (0.0) | 1 (2.8) | |||
Other | 5 (50.0) | 9 (25.0) | |||
Cycles (median (range)) | 5 (1–11) | 10 | 4 (1–16) | 36 | 0.293 |
Time surgery to recurrence—months | |||||
median (range) | 8.3 (1.9–13.3) | 4 | 8.6 (0.2–42.5) | 24 | 0.550 |
Time recurrence to last follow-up/death—months | |||||
median (range) | 22.5 (18.0–44.4) | 4 | 14.5 (1.6–79.3) | 24 | 0.341 |
Survival-Months | pCTX + TACE | pCTX | p | ||||||
---|---|---|---|---|---|---|---|---|---|
n | Median | Q1 | Q3 | n | Median | Q1 | Q3 | ||
since initial diagnosis | 14 | 30.1 | 16.7 | 46.8 | 59 | 17.4 | 6.3 | 25.1 | 0.019 |
since unresectability | 14 | 26.2 | 16.7 | 42.8 | 59 | 13.1 | 6.1 | 19.0 | 0.008 |
Survival of Propensity Score Matched Patients | |||||||||
since initial diagnosis | 10 | 26.8 | 13.6 | 46.8 | 10 | 9.4 | 4.2 | 21.2 | 0.051 |
since unresectability | 10 | 22.5 | 13.6 | 43.4 | 10 | 8.5 | 3.4 | 13.5 | 0.020 |
TACE Treatments | |
---|---|
median (range) | 3.5 (1–13) |
TACE method—no. (%) | |
cTACE (mitomycin C) | 2 (14.3) |
DEB-TACE (doxorubicin) | 9 (64.3) |
sequential combination | 3 (21.4) |
Time unresectability to first TACE treatment—days | |
median (range) | 84.5 (13–828) |
TACE/CTX relation—no. (%) | |
TACE before first CTX administration | 7 (50.0) |
TACE after first CTX administration | 7 (50.0) |
Time of hospitalization per TACE treatment—days | |
median (range) | 2 (1–26) |
Adverse events—no. (%) | |
no adverse events | 36 (56.3) |
postembolization syndrome | 24 (37.5) |
severe adverse events | 3 (4.7) |
other | 1 (1.6) |
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Gairing, S.J.; Thol, F.; Müller, L.; Hahn, F.; Thomaidis, T.; Czauderna, C.; Bartsch, F.; Pitton, M.B.; Marquardt, J.U.; Wörns, M.-A.; et al. The Addition of Transarterial Chemoembolization to Palliative Chemotherapy Extends Survival in Intrahepatic Cholangiocarcinoma. J. Clin. Med. 2021, 10, 2732. https://doi.org/10.3390/jcm10122732
Gairing SJ, Thol F, Müller L, Hahn F, Thomaidis T, Czauderna C, Bartsch F, Pitton MB, Marquardt JU, Wörns M-A, et al. The Addition of Transarterial Chemoembolization to Palliative Chemotherapy Extends Survival in Intrahepatic Cholangiocarcinoma. Journal of Clinical Medicine. 2021; 10(12):2732. https://doi.org/10.3390/jcm10122732
Chicago/Turabian StyleGairing, Simon Johannes, Felix Thol, Lukas Müller, Felix Hahn, Thomas Thomaidis, Carolin Czauderna, Fabian Bartsch, Michael Bernhard Pitton, Jens Uwe Marquardt, Marcus-Alexander Wörns, and et al. 2021. "The Addition of Transarterial Chemoembolization to Palliative Chemotherapy Extends Survival in Intrahepatic Cholangiocarcinoma" Journal of Clinical Medicine 10, no. 12: 2732. https://doi.org/10.3390/jcm10122732