https://orcid.org/0000-0002-5323-0614
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ABSTRACT
Objectives
To retrospectively compare the survival outcomes of thermal ablation plus chemotherapy to those of chemotherapy alone in patients with unresectable intrahepatic cholangiocarcinoma (ICC).
Methods
189 patients with unresectable ICC who received thermal ablation plus chemotherapy or chemotherapy alone as the initial treatment were identified . To avoid potential bias, 1:1 matching between groups was performed through propensity score matching. Overall survival (OS) was the primary endpoint. Clinical and tumor factors related to OS were analyzed through univariate and multivariate analyses.
Results
Of the enrolled patients, 55 received ablation plus chemotherapy, and 134 received chemotherapy alone. The median OS was 16.267 months for patients treated with combined therapy and 6.067 months for patients treated with chemotherapy alone (p = 0.000). The benefit of ablation plus chemotherapy was also preserved in the matched cohort, with a median OS of 15.233 months in the combined treatment group and 7.967 months in the chemotherapy group (p = 0.009). Univariate and multivariate analyses indicated that the type of treatment was an independent factor of OS (p < 0.05).
Conclusions
The combination of thermal ablation and systemic chemotherapy provides an opportunity to improve the prognosis of patients with unresectable ICC.
Article highlights
Thermal ablation combined with systemic chemotherapy offers several potential
benefits in patients with advanced cancer.
The addition of thermal ablation to systemic chemotherapy provides better survival
outcome for patients with unresectable ICC.
Our study shows for the first time that the addition of thermal ablation to chemotherapy is a feasible and effective option with potential benefits for patients with unresectable ICC.
Abbreviations
| ICC | = | Intrahepatic cholangiocarcinoma |
| RFA | = | Radiofrequency ablation |
| MWA | = | Microwave ablation |
| CT | = | Computed tomography |
| MRI | = | Magnetic resonance imaging |
| OS | = | Overall survival |
| HR | = | Hazard ratio |
| CI | = | Confidence interval |
| PSM | = | Propensity score matching |
| CEA | = | Carcinoembryonic antigen |
| CA19-9 | = | Cancer antigen 19-9 |
| KPS | = | Karnofsky Performance Status |
| HBV | = | Hepatitis B virus |
| HCV | = | Hepatitis C virus |
| AJCC | = | American Joint Committee on Cancer |
| DCs | = | Dendritic cells |
| NK | = | Natural killer |
| 5-Fu | = | 5-Fluorouracil |
Acknowledgments
The authors would like to thank Jiwei Li (Shanghai Life Genes Bio-technology Co., Ltd.) for helping with data analysis.
Declaration of interests
The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or conflict with the subject matter or materials discussed in this manuscript apart from those disclosed.
Reviewer disclosures
Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.
Author contributions
X Yan and L Zhuang contributed equally to this work: the conception and the design, data collection-analysis and interpretation; writing-reviewing and editing; Z Ning: Methodology and Software. P Wang: Visualization, Investigation. Z Meng: Supervision, Writing- Reviewing and Editing. All authors agree to be accountable for all aspects of the work.
Ethical approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.
Supplementary material
Supplemental data for this article can be accessed here