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

Lei Wang, Zi-Guo Lin, Qiao Ke, Jian-Ying Lou, Shu-Guo Zheng, Xin-Yu Bi, Jian-Ming Wang, Wei Guo, Fu-Yu Li, Jian Wang, Ya-Min Zheng, Jing-Dong Li, Shi Cheng, Wei-Ping Zhou, Yong-Yi Zeng, Lei Wang, Zi-Guo Lin, Qiao Ke, Jian-Ying Lou, Shu-Guo Zheng, Xin-Yu Bi, Jian-Ming Wang, Wei Guo, Fu-Yu Li, Jian Wang, Ya-Min Zheng, Jing-Dong Li, Shi Cheng, Wei-Ping Zhou, Yong-Yi Zeng

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; overall survival; propensity score matching; transarterial chemoembolization.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interest exists.

© The author(s).

Figures

Fig 1
Fig 1
Flow chart of patients' enrollment
Fig 2
Fig 2
Kaplan-Meier analysis of overall survival (A) and recurrence-free survival (B) in whole cohort, Kaplan-Meier analysis of overall survival (C) and recurrence-free survival (D) after propensity score matching
Fig 3
Fig 3
Kaplan-Meier analysis of overall survival based on 8th AJCC staging system. (A), subgroup of patients with stage I, (B) subgroup of patients with stage II and stage III
Fig 4
Fig 4
Kaplan-Meier analysis of overall survival based on risk factors. (A), subgroup of patients with “low risk”, (B) subgroup of patients with “high risk”.

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