Multicenter retrospective analysis of systemic chemotherapy for unresectable combined hepatocellular and cholangiocarcinoma
Satoshi Kobayashi,Takeshi Terashima,Satoshi Shiba,Yukio Yoshida,Ikuhiro Yamada,Shouta Iwadou,Shigeru Horiguchi,Hideaki Takahashi,Eiichiro Suzuki,Michihisa Moriguchi,Kunihiro Tsuji,Taiga Otsuka,Akinori Asagi,Yasushi Kojima,Ryoji Takada,Chigusa Morizane,Nobumasa Mizuno,Masafumi Ikeda,Makoto Ueno,Junji Furuse +19 more
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The platinum‐containing regimens such as gemcitabine/cisplatin were associated with more favorable outcomes than sorafenib monotherapy for unresectable combined hepatocellular and cholangiocarcinoma.Abstract:
We conducted a multicenter retrospective analysis to evaluate the efficacy of systemic chemotherapy for unresectable combined hepatocellular and cholangiocarcinoma. We enrolled 36 patients with pathologically proven, unresectable combined hepatocellular and cholangiocarcinoma treated with systemic chemotherapy. The log-rank test determined the significance of each prognostic factor. Elevated alpha-fetoprotein, carcinoembryonic antigen and carbohydrate antigen 19-9 levels were observed in 58.3%, 16.7% and 38.9% of patients, respectively. First-line chemotherapy included platinum-containing regimens consisting of gemcitabine/cisplatin (n = 12) and fluorouracil/cisplatin (n = 11), sorafenib (n = 5) and others (n = 8). The median overall and progression-free survival times were 8.9 and 2.8 months, respectively, with an overall response rate of 5.6%. Prognostic factors associated with negative outcomes included poor performance status, no prior primary tumor resection, a Child-Pugh class of B, and elevated carcinoembryonic antigen levels with a hazard ratio of 2.25, 2.48, 3.25 and 2.84 by univariate analysis, respectively. The median overall survival times of the gemcitabine/cisplatin, fluorouracil/cisplatin, sorafenib and other groups were 11.9, 10.2, 3.5 and 8.1 months, respectively. Multivariate analysis revealed that the overall survival of patients within the sorafenib monotherapy group was poor compared with platinum-containing regimens (HR: 15.83 [95% CI: 2.25-111.43], P = .006). All 7 patients in the sorafenib group had progressive disease, including 2 patients with second-line therapy. In conclusion, the platinum-containing regimens such as gemcitabine/cisplatin were associated with more favorable outcomes than sorafenib monotherapy for unresectable combined hepatocellular and cholangiocarcinoma.read more
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Journal ArticleDOI
Combined hepatocellular cholangiocarcinoma (cHCC-CC): an update of genetics, molecular biology, and therapeutic interventions.
TL;DR: Combined hepatocellular cholangiocarcinoma is a rare and aggressive primary hepatic malignancy with significant histological and biological heterogeneity.
Journal ArticleDOI
Combined hepatocellular-cholangiocarcinoma: An update.
TL;DR: Combined hepatocellular-cholangiocarcinoma (cHCC-CCA) is a tumour that exhibits both hepatocytic and biliary differentiation as mentioned in this paper.
Journal ArticleDOI
Therapy of Primary Liver Cancer.
TL;DR: These subtypes are distinct with respect to epidemiology, clinicopathological features, genetic alterations, and clinical managements, which are thoroughly summarized in this review.
Book ChapterDOI
Systemic therapy of liver cancer.
TL;DR: In this article, the authors summarize current approaches of systemic treatment in patients with liver cancer and summarize adjuvant and neoadjuvant therapy, although a few early phase studies show promising results.
Journal ArticleDOI
Combined hepatocellular-cholangiocarcinoma: An update on epidemiology, classification, diagnosis and management.
Dimitrios Schizas,Aikaterini Mastoraki,Eleni Routsi,Michail Papapanou,Dimitrios Tsapralis,Pantelis Vassiliu,Konstantinos Toutouzas,Evangelos Felekouras +7 more
TL;DR: Evaluation of tumor markers, carbohydrate antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA) along with imaging patterns provides better opportunities for CHC's preoperative diagnosis, and demonstrates an overlapping clinical and biological pattern between its malignant ingredients.
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