Efficacy and safety of microwave ablation combined with systemic chemotherapy in treatment of recurrent intrahepatic cholangiocarcinoma
10.3969/j.issn.1001-5256.2023.07.015
- VernacularTitle:微波消融联合全身化疗治疗复发性肝内胆管癌的有效性与安全性分析
- Author:
Chun WEI
1
;
Yu LIU
2
;
Bo LI
3
;
Ou JIANG
1
,
2
Author Information
1. Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, China
2. Fourth Department of Oncology, The Second People's Hospital of Neijiang, Neijiang, Sichuan 641000, China
3. Department of Hepatobiliary Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, China
- Publication Type:Original Article_Liver Neoplasm
- Keywords:
Cholangiocarcinoma;
Ablation Techniques;
Drug Therapy
- From:
Journal of Clinical Hepatology
2023;39(7):1609-1616
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the efficacy and safety of microwave ablation (MWA) combined with chemotherapy versus MWA alone in the treatment of recurrent intrahepatic cholangiocarcinoma (RICC). Methods A retrospective cohort study was conducted among the patients with RICC who received MWA+chemotherapy or MWA in The Second People's Hospital of Neijiang and The Affiliated Hospital of Southwest Medical University from January 2014 to March 2021, and their clinicopathological data were collected. The independent samples t -test was used for comparison of continuous data, and the chi-square test and the Fisher's exact test were used for comparison of categorical data. The Kaplan-Meier method was used to calculate progression-free survival (PFS) and overall survival (OS), and the Log-rank test was used for comparison of survival differences. Univariate and multivariate Cox proportional-hazards regression model analyses were used to investigate the risk factors for survival and prognosis. Results A total of 106 patients with RIC were enrolled, among whom there were 55 patients in the MWA+chemotherapy group and 51 in the MWA group. By the end of follow-up, the MWA+chemotherapy group had a median PFS of 15.0 months (95% confidence interval [ CI ]: 14.5-15.5), and the MWA group had a median PFS of 13.4 months (95% CI : 11.6-15.2), with a significant difference between the two groups ( χ 2 =9.624, P =0.002). The MWA+chemotherapy group had a median OS of 21.0 months (95% CI : 20.0-21.8), and the MWA group had a median OS of 18.0 months (95% CI : 16.3-19.7), with a significant difference between the two groups ( χ 2 =12.784, P < 0.001). The Cox regression analysis showed that tumor diameter (PFS: hazard ratio [ HR ]=0.425, 95% CI : 0.208-0.868, P =0.019; OS: HR =0.299, 95% CI : 0.121-0.739, P =0.009), time to recurrence (PFS: HR =7.064, 95% CI : 3.612-13.618, P < 0.001; OS: HR =2.341, 95% CI : 1.072-5.113, P =0.033), and combined chemotherapy (PFS: HR =0.138, 95% CI : 0.069-0.276, P < 0.001; OS: HR =0.175, 95% CI : 0.081-0.380, P < 0.001) were independent influencing factors for PFS and OS in patients with RICC. As for the common adverse reactions, there were no significant differences in the incidence rates of all adverse reactions except hematological toxicity ( χ 2 =12.524, P < 0.001). Conclusion Compared with MWA alone, MWA combined with chemotherapy can improve the prognosis of RICC and prolong PFS and OS, with safe and controllable side effects. Patients with tumor diameter > 5 cm, time to recurrence < 1 year, and absence of systemic chemotherapy tend to have a poor prognosis.
