Molecular factors associated with recurrence and survival following hepatectomy in patients with intrahepatic cholangiocarcinoma: A guide to adjuvant clinical trials. Issue 2 (7th October 2013)

• Record Type: Journal Article
• Authors: Schiffman, Suzanne C.; Nowacki, Michael R.; Spencer, Lena; McMasters, Kelly M.; Scoggins, Charles R.; Martin, Robert C.G.
• Is Part Of: Journal of surgical oncology. Volume 109:Issue 2(2014:Feb. 01)
• Page Start: 98
• Page End: 103
• Publication Date: 2013-10-07
• Subjects: Cancer -- Surgery -- Periodicals; Neoplasms -- Periodicals; 616
• DOI: 10.1002/jso.23459
• Languages: English
• ISSNs: 0022-4790

Abstract

<abstract abstract-type="main" xml:lang="en"> <title>Abstract</title> <sec id="jso23459-sec-0001" sec-type="section"> <title>Background</title> <p>This study sought to determine clinical and molecular factors related to recurrence and survival in patients with ICC following hepatectomy.</p> </sec> <sec id="jso23459-sec-0002" sec-type="section"> <title>Methods</title> <p>Database review identified 34 patients. Molecular markers (Ki67, p53, beta‐catenin) and standard pathological evaluations were performed.</p> </sec> <sec id="jso23459-sec-0003" sec-type="section"> <title>Results</title> <p>The most common resections were right (n = 11), extended right (n = 8), and left hepatectomy (n = 7). The 30‐ and 90 ‐day mortality rates were 5.9% and 11.8%. The median tumor size was 7.8 cm. Nine patients (26.5%) had positive lymph nodes and ten patients (29.4%) received adjuvant therapy. Median follow up was 33.5 months. The median disease‐free interval was 6 months. The median overall survival was 37.9 months. Univariate predictors of recurrence were tumor size (<italic>P</italic> = 0.02) and differentiation (<italic>P</italic> = 0.05). On multivariate analysis, differentiation (<italic>P</italic> = 0.03; OR = 0.38; 95% CI: 0.17–0.89) remained significant. Univariate predictors of survival were tumor size (<italic>P</italic> = 0.02), lymphovascular invasion (<italic>P</italic> = 0.02), satellite nodules (<italic>P</italic> = 0.006), beta‐catenin expression (<italic>P</italic> = 0.008), and recurrence (<italic>P</italic> = 0.026). On multivariate analyses, satellite lesions (<italic>P</italic> = 0.05, OR = 3.15, 95% CI: 0.96–10.4) and beta‐catenin (<italic>P</italic> = 0.04, OR = 3.23; 95% CI: 1.1–9.7) remained significant and differentiation (<italic>P</italic> = 0.045; OR = 0.42; 95% CI: 0.18–0.98) was an additional predictor.</p> </sec> <sec id="jso23459-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Future clinical trials could include certain molecular and pathologic factors to assist in determining the necessity and type of adjuvant therapy. <italic>J. Surg. Oncol. 2014 109:98–103</italic>. © 2013 Wiley Periodicals, Inc.</p> </sec> </abstract>