title: Serum gamma-glutamyl transferase levels affect the prognosis of patients with intrahepatic cholangiocarcinoma who receive postoperative adjuvant transcatheter arterial chemoembolization: A propensity score matching study.
abstract: BACKGROUND
  The postoperative prognosis of patients with intrahepatic cholangiocarcinoma (ICC) is far from satisfactory. Whether postoperative adjuvant transcatheter arterial chemoembolization (TACE) is effective for patients with ICC after R0 liver resection remains controversial.
  
  
  METHODS
  We retrospectively reviewed the data of 272 patients with ICC who received a radical hepatectomy at our center between 2000 and 2011. After the propensity score of postoperative TACE was calculated, 75 patients who received TACE were matched at a 1:2 ratios with 150 patients who did not receive TACE. Univariate and multivariate Cox analyses were performed to identify the independent predictors of overall survival.
  
  
  RESULTS
  The postoperative protective effect of adjuvant TACE was significantly influenced by serum gamma-glutamyl transferase (GGT) levels (P for interaction = 0.026). Postoperative TACE was not a significant predictor of overall survival (hazard ratio = 0.89, P = 0.704) in patients with GGT levels ≤ 54 U/L. Postoperative TACE was a significant predictor of overall survival in patients with GGT levels >54 U/L (hazard ratio = 0.44, P = 0.001). Regarding short-term outcomes, a total of 74 patients (32.9%) had varying degrees of complications, and the majority of these complications were grade I (18.7%) or II (10.2%).
  
  
  CONCLUSIONS
  The safety of postoperative TACE was validated, and the results suggest that only patients with elevated serum GGT levels will benefit from this treatment following curative liver resection for ICC.
authors.affiliation: Liver Cancer Institute and Zhongshan Hospital, Fudan University, Key Laboratory of Carcinogenesis and Cancer Invasion (Fudan University), Ministry of Education, 180 Feng Lin Road, Shanghai 200032, People's Republic of China; Department of Anesthesiology, Zhongshan Hospital, Fudan University, 180 Feng Lin Road, Shanghai 200032, People's Republic of China.
authors.forename: Zhufeng
authors.initials: Z
authors.lastname: Lu
authors.affiliation: Liver Cancer Institute and Zhongshan Hospital, Fudan University, Key Laboratory of Carcinogenesis and Cancer Invasion (Fudan University), Ministry of Education, 180 Feng Lin Road, Shanghai 200032, People's Republic of China.
authors.forename: Shuang
authors.initials: S
authors.lastname: Liu
authors.affiliation: Liver Cancer Institute and Zhongshan Hospital, Fudan University, Key Laboratory of Carcinogenesis and Cancer Invasion (Fudan University), Ministry of Education, 180 Feng Lin Road, Shanghai 200032, People's Republic of China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Yi
authors.affiliation: Liver Cancer Institute and Zhongshan Hospital, Fudan University, Key Laboratory of Carcinogenesis and Cancer Invasion (Fudan University), Ministry of Education, 180 Feng Lin Road, Shanghai 200032, People's Republic of China.
authors.forename: Xiaochun
authors.initials: X
authors.lastname: Ni
authors.affiliation: Liver Cancer Institute and Zhongshan Hospital, Fudan University, Key Laboratory of Carcinogenesis and Cancer Invasion (Fudan University), Ministry of Education, 180 Feng Lin Road, Shanghai 200032, People's Republic of China.
authors.forename: Jiaxing
authors.initials: J
authors.lastname: Wang
authors.affiliation: Liver Cancer Institute and Zhongshan Hospital, Fudan University, Key Laboratory of Carcinogenesis and Cancer Invasion (Fudan University), Ministry of Education, 180 Feng Lin Road, Shanghai 200032, People's Republic of China.
authors.forename: Jinlong
authors.initials: J
authors.lastname: Huang
authors.affiliation: Liver Cancer Institute and Zhongshan Hospital, Fudan University, Key Laboratory of Carcinogenesis and Cancer Invasion (Fudan University), Ministry of Education, 180 Feng Lin Road, Shanghai 200032, People's Republic of China.
authors.forename: Yipeng
authors.initials: Y
authors.lastname: Fu
authors.affiliation: Liver Cancer Institute and Zhongshan Hospital, Fudan University, Key Laboratory of Carcinogenesis and Cancer Invasion (Fudan University), Ministry of Education, 180 Feng Lin Road, Shanghai 200032, People's Republic of China.
authors.forename: Ya
authors.initials: Y
authors.lastname: Cao
authors.affiliation: Liver Cancer Institute and Zhongshan Hospital, Fudan University, Key Laboratory of Carcinogenesis and Cancer Invasion (Fudan University), Ministry of Education, 180 Feng Lin Road, Shanghai 200032, People's Republic of China.
authors.forename: Jian
authors.initials: J
authors.lastname: Zhou
authors.affiliation: Liver Cancer Institute and Zhongshan Hospital, Fudan University, Key Laboratory of Carcinogenesis and Cancer Invasion (Fudan University), Ministry of Education, 180 Feng Lin Road, Shanghai 200032, People's Republic of China.
authors.forename: Jia
authors.initials: J
authors.lastname: Fan
authors.affiliation: Liver Cancer Institute and Zhongshan Hospital, Fudan University, Key Laboratory of Carcinogenesis and Cancer Invasion (Fudan University), Ministry of Education, 180 Feng Lin Road, Shanghai 200032, People's Republic of China. Electronic address: qiu.shuangjian@zs-hospital.sh.cn.
authors.forename: Shuangjian
authors.initials: S
authors.lastname: Qiu
mesh_terms: D001650:Bile Duct Neoplasms / Q000401:mortality* / Q000628:therapy*; D016022:Case-Control Studies; D016461:Chemoembolization, Therapeutic; D018281:Cholangiocarcinoma / Q000401:mortality* / Q000628:therapy*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D057216:Propensity Score; D012189:Retrospective Studies; D005723:gamma-Glutamyltransferase / Q000097:blood*
chemical_list: D005723:gamma-Glutamyltransferase
keywords: Gamma-glutamyl transferase; Intrahepatic cholangiocarcinoma; Overall survival; Prognosis; Transcatheter arterial chemoembolization