Abstract
BackgroundIntrahepatic cholangiocarcinoma (ICC) has a poor prognosis and 40%-60% of patients present with advanced disease at the time of diagnosis. Transarterial chemoembolization (TACE) and hepatic arterial infusion chemotherapy (HAIC) have recently been used in unresectable ICC. The aim of this study was to compare the survival differences of unresectable ICC patients after TACE and HAIC treatment.MethodsBetween March 2011 and October 2019, a total of 126 patients with unresectable ICC, as evident from biopsies and imaging, and who had received TACE or HAIC were enrolled in this study. Baseline characteristics and survival differences were compared between the TACE and HAIC treatment groups.ResultsICC Patients had significantly higher survival rates after the HAIC treatment, compared with those after TACE treatment [1-year overall survival (OS) rates: 60.2% vs. 42.9%, 2-year OS rates: 38.7% vs. 29.4%, P=0.028; 1-year progression-free survival (PFS) rates: 15.0% vs. 20.0%, 2-year PFS rates: 0% vs. 0%, P=0.641; 1-year only intrahepatic PFS (OIPFS) rates: 35.0% vs. 24.4%, 2-year OIPFS rates: 13.1% vs. 14.6%, P = 0.026]. Multivariate Cox regression analysis showed that HAIC was a significant and independent factor for OS and OIPFS in the study cohort.ConclusionsHAIC is superior to TACE for treatment of unresectable ICC. A new tumor response evaluation procedure for HAIC treatment in unresectable ICC patients is needed to provide better therapeutic strategies. A randomized clinical trial comparing the survival benefits of HAIC and TACE is therefore being considered.
Highlights
Intrahepatic cholangiocarcinomas (ICC) arising from epithelial cells of the intrahepatic bile ducts account for 10%-20% of newly diagnosed hepatic malignancies and are increasing in incidence [1, 2]
Multivariate Cox regression analysis showed that hepatic arterial infusion chemotherapy (HAIC) was a significant and independent factor for overall survival (OS) and only intrahepatic PFS (OIPFS) in the study cohort
A total of 126 unresectable ICC patients were included in this study, including 69 patients receiving Transarterial chemoembolization (TACE) treatment and 57 patients receiving HAIC treatment
Summary
Intrahepatic cholangiocarcinomas (ICC) arising from epithelial cells of the intrahepatic bile ducts account for 10%-20% of newly diagnosed hepatic malignancies and are increasing in incidence [1, 2]. In the absence of specific clinical symptoms, 40%-60% of patients present with advanced disease at the time of diagnosis. The prognosis for patients with unresectable cholangiocarcinoma is very poor, with 2.5-7.5 months of median survival time in the absence of treatment [6]. Intrahepatic cholangiocarcinoma (ICC) has a poor prognosis and 40%60% of patients present with advanced disease at the time of diagnosis. Transarterial chemoembolization (TACE) and hepatic arterial infusion chemotherapy (HAIC) have recently been used in unresectable ICC. The aim of this study was to compare the survival differences of unresectable ICC patients after TACE and HAIC treatment
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