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Response evaluation of locoregional therapies in combined hepatocellular–cholangiocarcinoma and intrahepatic cholangiocarcinoma versus hepatocellular carcinoma: a propensity score matched study
To evaluate the response of locoregional therapy (LRT) on combined hepatocellular–cholangiocarcinoma (cHCC-CC) and intrahepatic cholangiocarcinoma (IHC) and compare their outcomes with propensity matched hepatocellular carcinoma (HCC) patients. From January 2011 to July 2020, 13 patients with cHCC-C...
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| Published in: | Clinical radiology 2022-02, Vol.77 (2), p.121-129 |
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| creator | Mukund, A. V. Srinivasan, S. Rana, S. Vijayaraghavan, R. Patidar, Y. Arora, V. Jindal, A. Choudhury, A. Shasthry, S.M. Sarin, S.K. |
| description | To evaluate the response of locoregional therapy (LRT) on combined hepatocellular–cholangiocarcinoma (cHCC-CC) and intrahepatic cholangiocarcinoma (IHC) and compare their outcomes with propensity matched hepatocellular carcinoma (HCC) patients.
From January 2011 to July 2020, 13 patients with cHCC-CC (11 men, two women, median age 56 years) and 15 IHC patients (10 men, five women, median age 60 years) were compared with 101 HCC patients (79 men, 22 women, median age 60 years) after LRT. All tumours were proven histologically. Among the 13 cHCC-CC patients, 11 received transarterial chemoembolisation (TACE), one received microwave ablation (MWA) and one received TACE with radiofrequency ablation (RFA). Of 15 IHC patients, eight received TACE, five received RFA, and one received MWA, and one received TACE with RFA. Propensity score matching (PSM) was done with conditional logistic regression adjusted for age, type of LRT, tumour specific features and Child–Pugh score.
After LRT, on univariate analysis an objective response was seen in 30% of cHCC-CC and 53% of IHC patients. PSM analysis demonstrated shorter progression-free survival (PFS; cHCC-CC versus HCC: 1.5 versus 7.5 months; IHC versus HCC: 6 versus 14 months, p |
| doi_str_mv | 10.1016/j.crad.2021.10.013 |
| format | article |
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From January 2011 to July 2020, 13 patients with cHCC-CC (11 men, two women, median age 56 years) and 15 IHC patients (10 men, five women, median age 60 years) were compared with 101 HCC patients (79 men, 22 women, median age 60 years) after LRT. All tumours were proven histologically. Among the 13 cHCC-CC patients, 11 received transarterial chemoembolisation (TACE), one received microwave ablation (MWA) and one received TACE with radiofrequency ablation (RFA). Of 15 IHC patients, eight received TACE, five received RFA, and one received MWA, and one received TACE with RFA. Propensity score matching (PSM) was done with conditional logistic regression adjusted for age, type of LRT, tumour specific features and Child–Pugh score.
After LRT, on univariate analysis an objective response was seen in 30% of cHCC-CC and 53% of IHC patients. PSM analysis demonstrated shorter progression-free survival (PFS; cHCC-CC versus HCC: 1.5 versus 7.5 months; IHC versus HCC: 6 versus 14 months, p<0.05), overall survival (OS; cHCC-CC versus HCC: 12 versus 28 months; IHC versus HCC: 18 versus 34 months, p<0.005), and poor objective response (cHCC-CC versus HCC: 25% versus 91%; IHC versus HCC: 58% versus 88%, p<0.05) in cHCC-CC and IHC patients versus HCC patients. Hypovascular tumour, macrovascular invasion, and infiltrative appearance were independent prognostic factors for OS in IHC patients.
cHCC-CC and IHC are aggressive tumours with a poor objective response, greater distant progression of the disease and shorter PFS and OS post LRT as compared to HCC.
•cHCC-CC and IHC are aggressive hepatic tumors with poor objective response post LRT.•It has a shorter progression free and overall survival after LRT as compared to HCC.•Tumour vascularity is a key factor in predicting tumor response before LRT.•TACE may be considered as a bridging therapy before surgery/liver transplantation.</description><identifier>ISSN: 0009-9260</identifier><identifier>EISSN: 1365-229X</identifier><identifier>DOI: 10.1016/j.crad.2021.10.013</identifier><identifier>PMID: 34789395</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Ablation Techniques - methods ; Aged ; Bile Duct Neoplasms - complications ; Bile Duct Neoplasms - surgery ; Bile Duct Neoplasms - therapy ; Bile Ducts, Intrahepatic - surgery ; Carcinoma, Hepatocellular - complications ; Carcinoma, Hepatocellular - surgery ; Carcinoma, Hepatocellular - therapy ; Chemoembolization, Therapeutic - methods ; Cholangiocarcinoma - complications ; Cholangiocarcinoma - surgery ; Cholangiocarcinoma - therapy ; Female ; Humans ; Liver Neoplasms - complications ; Liver Neoplasms - surgery ; Liver Neoplasms - therapy ; Male ; Middle Aged ; Propensity Score ; Radiofrequency Ablation ; Retrospective Studies ; Treatment Outcome</subject><ispartof>Clinical radiology, 2022-02, Vol.77 (2), p.121-129</ispartof><rights>2021 The Royal College of Radiologists</rights><rights>Copyright © 2021 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c356t-557a51cbdf4a008bad2e308822cd72ab830f88f2f7ba8f0ee89e5bc9ce779c673</citedby><cites>FETCH-LOGICAL-c356t-557a51cbdf4a008bad2e308822cd72ab830f88f2f7ba8f0ee89e5bc9ce779c673</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34789395$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mukund, A.</creatorcontrib><creatorcontrib>V. Srinivasan, S.</creatorcontrib><creatorcontrib>Rana, S.</creatorcontrib><creatorcontrib>Vijayaraghavan, R.</creatorcontrib><creatorcontrib>Patidar, Y.</creatorcontrib><creatorcontrib>Arora, V.</creatorcontrib><creatorcontrib>Jindal, A.</creatorcontrib><creatorcontrib>Choudhury, A.</creatorcontrib><creatorcontrib>Shasthry, S.M.</creatorcontrib><creatorcontrib>Sarin, S.K.</creatorcontrib><title>Response evaluation of locoregional therapies in combined hepatocellular–cholangiocarcinoma and intrahepatic cholangiocarcinoma versus hepatocellular carcinoma: a propensity score matched study</title><title>Clinical radiology</title><addtitle>Clin Radiol</addtitle><description>To evaluate the response of locoregional therapy (LRT) on combined hepatocellular–cholangiocarcinoma (cHCC-CC) and intrahepatic cholangiocarcinoma (IHC) and compare their outcomes with propensity matched hepatocellular carcinoma (HCC) patients.
From January 2011 to July 2020, 13 patients with cHCC-CC (11 men, two women, median age 56 years) and 15 IHC patients (10 men, five women, median age 60 years) were compared with 101 HCC patients (79 men, 22 women, median age 60 years) after LRT. All tumours were proven histologically. Among the 13 cHCC-CC patients, 11 received transarterial chemoembolisation (TACE), one received microwave ablation (MWA) and one received TACE with radiofrequency ablation (RFA). Of 15 IHC patients, eight received TACE, five received RFA, and one received MWA, and one received TACE with RFA. Propensity score matching (PSM) was done with conditional logistic regression adjusted for age, type of LRT, tumour specific features and Child–Pugh score.
After LRT, on univariate analysis an objective response was seen in 30% of cHCC-CC and 53% of IHC patients. PSM analysis demonstrated shorter progression-free survival (PFS; cHCC-CC versus HCC: 1.5 versus 7.5 months; IHC versus HCC: 6 versus 14 months, p<0.05), overall survival (OS; cHCC-CC versus HCC: 12 versus 28 months; IHC versus HCC: 18 versus 34 months, p<0.005), and poor objective response (cHCC-CC versus HCC: 25% versus 91%; IHC versus HCC: 58% versus 88%, p<0.05) in cHCC-CC and IHC patients versus HCC patients. Hypovascular tumour, macrovascular invasion, and infiltrative appearance were independent prognostic factors for OS in IHC patients.
cHCC-CC and IHC are aggressive tumours with a poor objective response, greater distant progression of the disease and shorter PFS and OS post LRT as compared to HCC.
•cHCC-CC and IHC are aggressive hepatic tumors with poor objective response post LRT.•It has a shorter progression free and overall survival after LRT as compared to HCC.•Tumour vascularity is a key factor in predicting tumor response before LRT.•TACE may be considered as a bridging therapy before surgery/liver transplantation.</description><subject>Ablation Techniques - methods</subject><subject>Aged</subject><subject>Bile Duct Neoplasms - complications</subject><subject>Bile Duct Neoplasms - surgery</subject><subject>Bile Duct Neoplasms - therapy</subject><subject>Bile Ducts, Intrahepatic - surgery</subject><subject>Carcinoma, Hepatocellular - complications</subject><subject>Carcinoma, Hepatocellular - surgery</subject><subject>Carcinoma, Hepatocellular - therapy</subject><subject>Chemoembolization, Therapeutic - methods</subject><subject>Cholangiocarcinoma - complications</subject><subject>Cholangiocarcinoma - surgery</subject><subject>Cholangiocarcinoma - therapy</subject><subject>Female</subject><subject>Humans</subject><subject>Liver Neoplasms - complications</subject><subject>Liver Neoplasms - surgery</subject><subject>Liver Neoplasms - therapy</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Propensity Score</subject><subject>Radiofrequency Ablation</subject><subject>Retrospective Studies</subject><subject>Treatment Outcome</subject><issn>0009-9260</issn><issn>1365-229X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNp9kc2KFDEUhYMoTjv6Ai4kSzfVplJdPxE3MvgHA4IouAu3bm7ZaaqSMkk19M538JF8E5_ElD3OQsRVuDffOZzLYexxKbalKJtnhy0GMFspZJkXW1FWd9imrJq6kFJ9vss2QghVKNmIC_YgxsM67uTuPruodm2nKlVv2I8PFGfvInE6wrhAst5xP_DRow_0JU8w8rSnALOlyK3j6KfeOjJ8TzMkjzSOywjh57fvuPcjuKxBCGidn4CDM1mTAvyGLfJ_MEcKcYl_2fHb_-cc-Bz8TC7adOJxzcUnSLjPGWJazOkhuzfAGOnRzXvJPr1-9fHqbXH9_s27q5fXBVZ1k4q6bqEusTfDDoToejCSKtF1UqJpJfRdJYauG-TQ9tANgqhTVPeokNpWYdNWl-zp2TfH-bpQTHqycQ0MjvwStayVEm1diRWVZxSDjzHQoOdgJwgnXQq9lqcPei1Pr-Wtu1xeFj258V_6icyt5E9bGXhxBihfebQUdERLDsnYQJi08fZ__r8AR_i0aw</recordid><startdate>202202</startdate><enddate>202202</enddate><creator>Mukund, A.</creator><creator>V. Srinivasan, S.</creator><creator>Rana, S.</creator><creator>Vijayaraghavan, R.</creator><creator>Patidar, Y.</creator><creator>Arora, V.</creator><creator>Jindal, A.</creator><creator>Choudhury, A.</creator><creator>Shasthry, S.M.</creator><creator>Sarin, S.K.</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202202</creationdate><title>Response evaluation of locoregional therapies in combined hepatocellular–cholangiocarcinoma and intrahepatic cholangiocarcinoma versus hepatocellular carcinoma: a propensity score matched study</title><author>Mukund, A. ; V. Srinivasan, S. ; Rana, S. ; Vijayaraghavan, R. ; Patidar, Y. ; Arora, V. ; Jindal, A. ; Choudhury, A. ; Shasthry, S.M. ; Sarin, S.K.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-557a51cbdf4a008bad2e308822cd72ab830f88f2f7ba8f0ee89e5bc9ce779c673</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Ablation Techniques - methods</topic><topic>Aged</topic><topic>Bile Duct Neoplasms - complications</topic><topic>Bile Duct Neoplasms - surgery</topic><topic>Bile Duct Neoplasms - therapy</topic><topic>Bile Ducts, Intrahepatic - surgery</topic><topic>Carcinoma, Hepatocellular - complications</topic><topic>Carcinoma, Hepatocellular - surgery</topic><topic>Carcinoma, Hepatocellular - therapy</topic><topic>Chemoembolization, Therapeutic - methods</topic><topic>Cholangiocarcinoma - complications</topic><topic>Cholangiocarcinoma - surgery</topic><topic>Cholangiocarcinoma - therapy</topic><topic>Female</topic><topic>Humans</topic><topic>Liver Neoplasms - complications</topic><topic>Liver Neoplasms - surgery</topic><topic>Liver Neoplasms - therapy</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Propensity Score</topic><topic>Radiofrequency Ablation</topic><topic>Retrospective Studies</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mukund, A.</creatorcontrib><creatorcontrib>V. Srinivasan, S.</creatorcontrib><creatorcontrib>Rana, S.</creatorcontrib><creatorcontrib>Vijayaraghavan, R.</creatorcontrib><creatorcontrib>Patidar, Y.</creatorcontrib><creatorcontrib>Arora, V.</creatorcontrib><creatorcontrib>Jindal, A.</creatorcontrib><creatorcontrib>Choudhury, A.</creatorcontrib><creatorcontrib>Shasthry, S.M.</creatorcontrib><creatorcontrib>Sarin, S.K.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mukund, A.</au><au>V. Srinivasan, S.</au><au>Rana, S.</au><au>Vijayaraghavan, R.</au><au>Patidar, Y.</au><au>Arora, V.</au><au>Jindal, A.</au><au>Choudhury, A.</au><au>Shasthry, S.M.</au><au>Sarin, S.K.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Response evaluation of locoregional therapies in combined hepatocellular–cholangiocarcinoma and intrahepatic cholangiocarcinoma versus hepatocellular carcinoma: a propensity score matched study</atitle><jtitle>Clinical radiology</jtitle><addtitle>Clin Radiol</addtitle><date>2022-02</date><risdate>2022</risdate><volume>77</volume><issue>2</issue><spage>121</spage><epage>129</epage><pages>121-129</pages><issn>0009-9260</issn><eissn>1365-229X</eissn><abstract>To evaluate the response of locoregional therapy (LRT) on combined hepatocellular–cholangiocarcinoma (cHCC-CC) and intrahepatic cholangiocarcinoma (IHC) and compare their outcomes with propensity matched hepatocellular carcinoma (HCC) patients.
From January 2011 to July 2020, 13 patients with cHCC-CC (11 men, two women, median age 56 years) and 15 IHC patients (10 men, five women, median age 60 years) were compared with 101 HCC patients (79 men, 22 women, median age 60 years) after LRT. All tumours were proven histologically. Among the 13 cHCC-CC patients, 11 received transarterial chemoembolisation (TACE), one received microwave ablation (MWA) and one received TACE with radiofrequency ablation (RFA). Of 15 IHC patients, eight received TACE, five received RFA, and one received MWA, and one received TACE with RFA. Propensity score matching (PSM) was done with conditional logistic regression adjusted for age, type of LRT, tumour specific features and Child–Pugh score.
After LRT, on univariate analysis an objective response was seen in 30% of cHCC-CC and 53% of IHC patients. PSM analysis demonstrated shorter progression-free survival (PFS; cHCC-CC versus HCC: 1.5 versus 7.5 months; IHC versus HCC: 6 versus 14 months, p<0.05), overall survival (OS; cHCC-CC versus HCC: 12 versus 28 months; IHC versus HCC: 18 versus 34 months, p<0.005), and poor objective response (cHCC-CC versus HCC: 25% versus 91%; IHC versus HCC: 58% versus 88%, p<0.05) in cHCC-CC and IHC patients versus HCC patients. Hypovascular tumour, macrovascular invasion, and infiltrative appearance were independent prognostic factors for OS in IHC patients.
cHCC-CC and IHC are aggressive tumours with a poor objective response, greater distant progression of the disease and shorter PFS and OS post LRT as compared to HCC.
•cHCC-CC and IHC are aggressive hepatic tumors with poor objective response post LRT.•It has a shorter progression free and overall survival after LRT as compared to HCC.•Tumour vascularity is a key factor in predicting tumor response before LRT.•TACE may be considered as a bridging therapy before surgery/liver transplantation.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>34789395</pmid><doi>10.1016/j.crad.2021.10.013</doi><tpages>9</tpages></addata></record> |
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| source | ScienceDirect Journals |
| subjects | Ablation Techniques - methods Aged Bile Duct Neoplasms - complications Bile Duct Neoplasms - surgery Bile Duct Neoplasms - therapy Bile Ducts, Intrahepatic - surgery Carcinoma, Hepatocellular - complications Carcinoma, Hepatocellular - surgery Carcinoma, Hepatocellular - therapy Chemoembolization, Therapeutic - methods Cholangiocarcinoma - complications Cholangiocarcinoma - surgery Cholangiocarcinoma - therapy Female Humans Liver Neoplasms - complications Liver Neoplasms - surgery Liver Neoplasms - therapy Male Middle Aged Propensity Score Radiofrequency Ablation Retrospective Studies Treatment Outcome |
| title | Response evaluation of locoregional therapies in combined hepatocellular–cholangiocarcinoma and intrahepatic cholangiocarcinoma versus hepatocellular carcinoma: a propensity score matched study |
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