Abstract
Background and PurposeAbout 70% of patients with radical surgery Cholangiocarcinoma (CCA) have recurrence and metastasis. There are few studies on the relationship between CCA adjuvant chemotherapy (mono or combined therapy), recurrence pattern (local, regional, distant recurrence) and prognosis [(Disease free survival, DFS), (Overall survival, OS)] after radical surgery. This study focuses on the correlation between CCA adjuvant chemotherapy, recurrence pattern and prognosis.MethodsThe study involved retrospective analysis of data: preoperative hematology, clinical pathology, adjuvant chemotherapy regimens, recurrence pattern, DFS and OS, of 207 patients with CCA. Chi-square test was used to analyze the correlation between related factors and postoperative recurrence. Survival curves were plotted by Kaplan-Meier method, P-values were calculated by Log-rank for univariate analysis, multivariate COX regression method for multivariate analysis.ResultsUsing chi-square test, there were correlations between high carbohydrate antigen 19-9 level(CA19-9≥35), vascular invasion, single-agent adjuvant chemotherapy and postoperative recurrences (p=0.04, p=0.04, p=0.02), COX multivariate regression analysis showed that adjuvant chemotherapy (single vs. doublet drug regimen) was an independent prognostic factor for DFS (11.0 vs. 24.6 months, HR=2.88, P=0.01), whereas recurrence pattern (local vs. distant; regional vs. distant) was an independent prognostic factor for OS (31.2 months vs. 20.4 months, HR=0.58, p=0.01; 32.0 months vs. 20.4 months, HR=0.51, p=0.01).ConclusionAdjuvant chemotherapy regimen was an independent prognostic factor of DFS, whereas recurrence patterns were independent prognostic factors for OS. adjuvant chemotherapy with doublet drug regimen was correlated with longer DFS, and different recurrence modes affect OS.
Highlights
According to the 2015 China Cancer Data Report, the number of new liver cancer patients and deaths was 466,100 and 422,100, respectively [1], accounting for 50% of the total number of liver cancer cases and deaths worldwide [2]
Chisquare test showed that high carbohydrate antigen 19-9 (CA19-9) (≥35U/ml), vascular invasion, and single drug adjuvant chemotherapy are associated with postoperative recurrence (p
WBC, white blood cell; HB, hemoglobin; ALB, albumin; AFP, alpha fetoprotein; CEA, carcinoembryonic antigen; CA19-9, carbohydrate antigen 19-9; Single drug, mainly 5-fluorouracil (S-1 or capecitabine) adjuvant chemotherapy was administrated as follow:S-1 50 mg/m2 or capecitabine 1250 mg/m2 administered orally twice daily on days 1–14 for a 3-week cycle; Doublet drugs, mainly gemcitabine + capecitabine or S-1 adjuvant chemotherapy was administrated as follow: gemcitabine 1000 mg/m2 administered intravenously on day 1 and S-1 50 mg/m2 or capecitabine 1000 mg/m2 administered orally twice daily on days 1–14 for a 3-week cycle
Summary
According to the 2015 China Cancer Data Report, the number of new liver cancer patients and deaths was 466,100 and 422,100, respectively [1], accounting for 50% of the total number of liver cancer cases and deaths worldwide [2]. There are limited studies on the relationship between CCA and adjuvant chemotherapy (single drug, doublet drugs), recurrence pattern (local, regional, distant recurrence) and prognosis [(Disease free survival, DFS), OS] after radical surgery (R0 or R1 resection). All patients included in this study received S1/capecitabine or gemcitabine+S1/ capecitabine regimen. The single drug regimen was received in oral S1/capecitabine for at least 4 cycles, and the doublet regimen was gemcitabine +S1/capecitabine for at least 2 cycles, and the dose should be adjusted according to toxic and side effects. There are few studies on the relationship between CCA adjuvant chemotherapy (mono or combined therapy), recurrence pattern (local, regional, distant recurrence) and prognosis [(Disease free survival, DFS), (Overall survival, OS)] after radical surgery. This study focuses on the correlation between CCA adjuvant chemotherapy, recurrence pattern and prognosis
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
