title: Postoperative adjuvant transcatheter arterial chemoembolisation improves survival of intrahepatic cholangiocarcinoma patients with poor prognostic factors: results of a large monocentric series.
abstract: BACKGROUND
  The prognosis of patients with intrahepatic cholangiocarcinoma (ICC) is currently unsatisfactory. The aims of this study were to identify prognostic factors after curative ICC resection, and to evaluate the effects of postoperative transcatheter arterial chemoembolisation (TACE).
  
  
  METHODS
  A retrospective analysis was conducted of 114 ICC patients who underwent curative resection from January 2005 to December 2006. Relationships between survival and clinicopathological factors were evaluated using univariate and multivariate analyses. The benefits of adjuvant TACE were investigated separately.
  
  
  RESULTS
  The cumulative 1-, 3-, and 5-year survival rates were 63%, 26%, and 15%, respectively. Multivariate analysis revealed that tumour size ≥ 5 cm (hazard ratio [HR] 1.875, 95% CI 1.139-3.088, P=0.013) and advanced TNM stage (stage III or IV) (HR 1.681, 95% CI 1.035-2.732, P=0.036) were independently associated with poor prognosis. Fifty-seven patients underwent adjuvant TACE. In patients with poor prognostic factors, TACE improved the survival rate (P<0.001). However, in patients without poor prognostic factors, TACE did not significantly change the survival rate (P=0.724).
  
  
  CONCLUSIONS
  Postoperative adjuvant TACE can prolong survival in ICC patients with tumour size ≥ 5 cm or advanced TNM stage.
authors.affiliation: The Fifth Department of Hepatic Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, No. 225 Changhai Road, Shanghai 200438, PR China.
authors.forename: Z F
authors.initials: ZF
authors.lastname: Wu
authors.forename: H B
authors.initials: HB
authors.lastname: Zhang
authors.forename: N
authors.initials: N
authors.lastname: Yang
authors.forename: W C
authors.initials: WC
authors.lastname: Zhao
authors.forename: Y
authors.initials: Y
authors.lastname: Fu
authors.forename: G S
authors.initials: GS
authors.lastname: Yang
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D001650:Bile Duct Neoplasms / Q000209:etiology / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D001653:Bile Ducts, Intrahepatic; D014408:Biomarkers, Tumor / Q000032:analysis; D018395:CA-19-9 Antigen / Q000032:analysis; D016461:Chemoembolization, Therapeutic / Q000379:methods; D017024:Chemotherapy, Adjuvant; D018281:Cholangiocarcinoma / Q000209:etiology / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D005260:Female; D006499:Hepatic Artery; D006525:Hepatitis, Viral, Human / Q000150:complications; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis
chemical_list: D014408:Biomarkers, Tumor; D018395:CA-19-9 Antigen