Transcatheter arterial chemoembolization after surgical excision of intrahepatic cholangiocarcinoma:an analysis of outcomes

Abstract

Objective:To observe the therapeutic effects of transcatheter arterial chemoembolization(TACE) on intrahepatic cholangiocarcinoma(ICC) patients who received surgical excision,so as to discuss whether TACE should be routinely used for ICC patients after surgical resection to prevent recurrence.Methods: The clinical data of 80 pathologically-confirmed ICC patients,who received surgical excision in our hospital from July,2005 to December,2005,were retrospectively analyzed.Thirty-six cases received TACE treatment after operation(group A),and the others did not receive TACE(group B).The general data and laboratory findings were compared between the two groups.The survival periods(six months,1 year,2 years and 3 years) of the patients were observed and statistically analyzed.The risk factors for survival were also analyzed.Results: There were no significant differences in sex,age,history of hepatitis B virus infection,liver cirrhosis,laboratory findings,including hepatitis B surface antigen,alpha-fetoprotein,carcinoembryonic antigen(CEA),CA19-9(CA19-9),alanine aminotransferase and total bilirubin,tumor size,number of tumors,and hilar lymph node metastases(P0.05).The half-year,1-year,2-year and 3-year survival rates in the two groups were 80.6% vs 81.8%(χ2= 0.082 2,P=0.774 4),63.9% vs 65.9%(χ2= 0.418 7,P=0.517 6),25.0% vs 22.7%(χ2= 0.118 7,P=0.730 5),and 8.3% vs 9.1%(χ2= 0.115 7,P=0.733 7),respectively.There were no significant differences between the two groups.COX regression analysis showed that CEA,CA19-9 and hilar lymph node metastasis were the independent risk factors of survival rate,with the coefficients being 2.930(P=0.012 5),19.913(P0.001),and 17.791(P0.001),respectively.Postoperative TACE was not an independent factor of patient survival.Conclusion: Postoperative TACE may not improve the survival rate of ICC;therefore routine TACE should not be recommended for ICC patients after TACE to prevent possible recurrence.