Risk Factors and Outcomes of Early Relapse After Curative Resection of Intrahepatic Cholangiocarcinoma
Early relapse after hepatectomy for intrahepatic cholangiocarcinoma (ICC) has a tremendous influence on the long-term survival outcomes of ICC patients. The purpose of our study was to investigate risk factors for early tumor relapse and confirm whether early relapse was correlated with ICC patients...
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Frontiers Media S.A.
2019-09-01
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Series: | Frontiers in Oncology |
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Online Access: | https://www.frontiersin.org/article/10.3389/fonc.2019.00854/full |
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record_format |
Article |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Hua Yang Jie Wang Zehuan Li Yi Yang Liuxiao Yang Yong Zhang Yinghong Shi Ya Cao Jian Zhou Jian Zhou Jian Zhou Zheng Wang Qing Chen |
spellingShingle |
Hua Yang Jie Wang Zehuan Li Yi Yang Liuxiao Yang Yong Zhang Yinghong Shi Ya Cao Jian Zhou Jian Zhou Jian Zhou Zheng Wang Qing Chen Risk Factors and Outcomes of Early Relapse After Curative Resection of Intrahepatic Cholangiocarcinoma Frontiers in Oncology intrahepatic cholangiocarcinoma early relapse CA19-9 liver resection prognosis |
author_facet |
Hua Yang Jie Wang Zehuan Li Yi Yang Liuxiao Yang Yong Zhang Yinghong Shi Ya Cao Jian Zhou Jian Zhou Jian Zhou Zheng Wang Qing Chen |
author_sort |
Hua Yang |
title |
Risk Factors and Outcomes of Early Relapse After Curative Resection of Intrahepatic Cholangiocarcinoma |
title_short |
Risk Factors and Outcomes of Early Relapse After Curative Resection of Intrahepatic Cholangiocarcinoma |
title_full |
Risk Factors and Outcomes of Early Relapse After Curative Resection of Intrahepatic Cholangiocarcinoma |
title_fullStr |
Risk Factors and Outcomes of Early Relapse After Curative Resection of Intrahepatic Cholangiocarcinoma |
title_full_unstemmed |
Risk Factors and Outcomes of Early Relapse After Curative Resection of Intrahepatic Cholangiocarcinoma |
title_sort |
risk factors and outcomes of early relapse after curative resection of intrahepatic cholangiocarcinoma |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Oncology |
issn |
2234-943X |
publishDate |
2019-09-01 |
description |
Early relapse after hepatectomy for intrahepatic cholangiocarcinoma (ICC) has a tremendous influence on the long-term survival outcomes of ICC patients. The purpose of our study was to investigate risk factors for early tumor relapse and confirm whether early relapse was correlated with ICC patients' long-term survival outcomes. Three hundred and twenty-two consecutive ICC patients undergoing partial hepatectomy at Liver Surgery Department of Zhongshan Hospital (Fudan University, Shanghai, China) between January 2005 and December 2011 were included in this retrospectively study. The definition of early relapse had been described as tumor relapse within 24 months after hepatectomy in ICC patients. We identified a total of 168 ICC patients with early relapse and 23 ICC patients with late relapse after hepatectomy. From the time of relapse, the long-term survival outcomes were worse among patients who had early vs. late relapse (median OS 16.5 vs. 44.7 months, respectively; P < 0.0001). The overall survival of the early relapse group was lower than that of the late relapse group (P < 0.0001). Multivariate Cox regression analysis indicated that multiple tumors (hazard ratio [HR], 1.951; 95% CI, 1.382–2.755; P < 0.001), lymphonodus metastasis (HR, 1.517; 95% CI, 1.061–2.168; P = 0.022), and higher serum CA19-9 levels (HR, 1.495; 95% CI, 1.095–2.039; P = 0.011) were independent risk factors of early relapse. Moreover, multiple tumors (HR, 1.641; 95% CI, 1.120–2.406; P = 0.011), lymphonodus metastasis (HR, 2.008; 95% CI, 1.367–2.949; P < 0.001), elevated NLR (HR, 1.921; 95% CI, 1.331–2.774; P < 0.001) and higher serum CA19-9 levels (HR, 1.990; 95% CI, 1.409–2.812; P < 0.001) were independent predictors of overall survival for ICC patients with early relapse. Collectively, our findings demonstrated that multiple tumors, lymphonodus metastasis, and higher serum CA19-9 levels were associated with the increased risks of early relapse and worse prognoses of ICC after curative-intent resection. |
topic |
intrahepatic cholangiocarcinoma early relapse CA19-9 liver resection prognosis |
url |
https://www.frontiersin.org/article/10.3389/fonc.2019.00854/full |
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doaj-af7c891484c247e182029993a7e053db2020-11-25T02:02:00ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2019-09-01910.3389/fonc.2019.00854484784Risk Factors and Outcomes of Early Relapse After Curative Resection of Intrahepatic CholangiocarcinomaHua Yang0Jie Wang1Zehuan Li2Yi Yang3Liuxiao Yang4Yong Zhang5Yinghong Shi6Ya Cao7Jian Zhou8Jian Zhou9Jian Zhou10Zheng Wang11Qing Chen12Department of General Surgery, Shanghai Public Health Clinical Center, Zhongshan Hospital (South), Fudan University, Shanghai, ChinaENT Institute and Otorhinolaryngology Department, Eye & ENT Hospital, Fudan University, Shanghai, ChinaDepartment of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, ChinaKey Laboratory of Carcinogenesis and Cancer Invasion, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Ministry of Education, Shanghai, ChinaKey Laboratory of Carcinogenesis and Cancer Invasion, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Ministry of Education, Shanghai, ChinaDepartment of General Surgery, Shanghai Public Health Clinical Center, Zhongshan Hospital (South), Fudan University, Shanghai, ChinaKey Laboratory of Carcinogenesis and Cancer Invasion, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Ministry of Education, Shanghai, ChinaKey Laboratory of Carcinogenesis and Cancer Invasion, Cancer Research Institute, Central South University, Ministry of Education, Changsha, ChinaKey Laboratory of Carcinogenesis and Cancer Invasion, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Ministry of Education, Shanghai, ChinaInstitute of Biomedical Sciences, Fudan University, Shanghai, ChinaState key Laboratory of Genetic Engineering, Fudan University, Shanghai, ChinaKey Laboratory of Carcinogenesis and Cancer Invasion, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Ministry of Education, Shanghai, ChinaDepartment of General Surgery, Shanghai Public Health Clinical Center, Zhongshan Hospital (South), Fudan University, Shanghai, ChinaEarly relapse after hepatectomy for intrahepatic cholangiocarcinoma (ICC) has a tremendous influence on the long-term survival outcomes of ICC patients. The purpose of our study was to investigate risk factors for early tumor relapse and confirm whether early relapse was correlated with ICC patients' long-term survival outcomes. Three hundred and twenty-two consecutive ICC patients undergoing partial hepatectomy at Liver Surgery Department of Zhongshan Hospital (Fudan University, Shanghai, China) between January 2005 and December 2011 were included in this retrospectively study. The definition of early relapse had been described as tumor relapse within 24 months after hepatectomy in ICC patients. We identified a total of 168 ICC patients with early relapse and 23 ICC patients with late relapse after hepatectomy. From the time of relapse, the long-term survival outcomes were worse among patients who had early vs. late relapse (median OS 16.5 vs. 44.7 months, respectively; P < 0.0001). The overall survival of the early relapse group was lower than that of the late relapse group (P < 0.0001). Multivariate Cox regression analysis indicated that multiple tumors (hazard ratio [HR], 1.951; 95% CI, 1.382–2.755; P < 0.001), lymphonodus metastasis (HR, 1.517; 95% CI, 1.061–2.168; P = 0.022), and higher serum CA19-9 levels (HR, 1.495; 95% CI, 1.095–2.039; P = 0.011) were independent risk factors of early relapse. Moreover, multiple tumors (HR, 1.641; 95% CI, 1.120–2.406; P = 0.011), lymphonodus metastasis (HR, 2.008; 95% CI, 1.367–2.949; P < 0.001), elevated NLR (HR, 1.921; 95% CI, 1.331–2.774; P < 0.001) and higher serum CA19-9 levels (HR, 1.990; 95% CI, 1.409–2.812; P < 0.001) were independent predictors of overall survival for ICC patients with early relapse. Collectively, our findings demonstrated that multiple tumors, lymphonodus metastasis, and higher serum CA19-9 levels were associated with the increased risks of early relapse and worse prognoses of ICC after curative-intent resection.https://www.frontiersin.org/article/10.3389/fonc.2019.00854/fullintrahepatic cholangiocarcinomaearly relapseCA19-9liver resectionprognosis |