J Cancer 2020; 11(14):4115-4122. doi:10.7150/jca.40358

Research Paper

Adjuvant transarterial chemoembolization following radical resection for intrahepatic cholangiocarcinoma: A multi-center retrospective study

Lei Wang1*, Zi-Guo Lin2*, Qiao Ke2*, Jian-Ying Lou3, Shu-Guo Zheng4, Xin-Yu Bi5, Jian-Ming Wang6, Wei Guo7, Fu-Yu Li8, Jian Wang9, Ya-Min Zheng10, Jing-Dong Li11, Shi Cheng12, Wei-Ping Zhou13✉, Yong-Yi Zeng1,2✉

1. Department of Radiation Oncology, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou China, 350025
2. Department of Hepatobiliary Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou China, 350025
3. Department of hepatobiliary surgery, the Second Hospital affiliated to Zhejiang University, Hangzhou, China, 310009
4. Department of hepatobiliary surgery, the Southwest Hospital affiliated to the Army Medical University, Chongqing, China, 400038
5. Department of Hepatobiliary Surgery, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China, 100021
6. Department of hepatobiliary surgery, Tongji Hospital affiliated to affiliated to Tongji Medical College, Huazhong University of Science &Technology, Wuhan, Hubei, China, 430030
7. Department of Hepatobiliary Surgery, Beijing Friendship Hospital affiliated to Capital Medical University, Beijing, China, 100053
8. Department of Hepatobiliary Surgery, the West China Hospital of Sichuan University, Chengdu, China, 610041
9. Department of hepatobiliary surgery, Renji Hospital affiliated to Shanghai Jiaotong University, Shanghai, China, 200127
10. Department of Hepatobiliary Surgery, Xuanwu Hospital affiliated to Capital Medical University, Beijing, China, 100050
11. Department of Hepatobiliary Surgery, the affiliated Hospital of Chuanbei Medical University, Nanchong, China, 637000
12. Department of Hepatobiliary Surgery, Tiantan Hospital affiliated to Capital Medical University, Beijing, China, 100050
13. Department of Hepatobiliary Surgery Ⅲ, Eastern Hepatobiliary Surgery Hospital, Secondary Military Medical University, Shanghai China, 200438
* Authors contributed equally in this study

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Citation:
Wang L, Lin ZG, Ke Q, Lou JY, Zheng SG, Bi XY, Wang JM, Guo W, Li FY, Wang J, Zheng YM, Li JD, Cheng S, Zhou WP, Zeng YY. Adjuvant transarterial chemoembolization following radical resection for intrahepatic cholangiocarcinoma: A multi-center retrospective study. J Cancer 2020; 11(14):4115-4122. doi:10.7150/jca.40358. Available from http://www.jcancer.org/v11p4115.htm

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Abstract

Background and Aims: The prognosis of intrahepatic cholangiocarcinoma (ICC) after radical resection is far from satisfactory, but the effect of postoperative transarterial chemoembolization (p-TACE) remains controversial. This multi-center retrospective study was to evaluate the clinical value of p-TACE and identify the selected patients who would benefit from p-TACE.

Methods: Data of ICC patients who underwent radical resection with/without p-TACE therapy was obtained from 12 hepatobiliary centers in China between Jan 2014 and Jan 2017. Overall survival (OS) was set as the primary endpoint, which was analyzed by the Kaplan-Meier method before and after propensity score matching (PSM). Subgroup analysis was conducted based on the established staging system and survival risk stratification.

Results: A total of 335 patients were enrolled in this study, including 39 patients in the p-TACE group and 296 patients in the non-TACE group. Median OS in the p-TACE group was longer than that in the non-TACE group (63.0 months vs. 18.0 months, P=0.041), which was confirmed after 1:1 PSM (P=0.009). According to the 8th TNM staging system, patients with stage II and stage III stage would be benefited from p-TACE (P=0.021). Subgroup analysis stratified by risk factors showed that p-TACE could only benefit patients with risk factors <2 (P=0.027).

Conclusion: Patients with ICC should be recommended to receive p-TACE following radical resection, especially for those with stage II, stage III or risk factors <2. However, the conclusion deserved further validation.

Keywords: intrahepatic cholangiocarcinoma, transarterial chemoembolization, overall survival, propensity score matching