Author:
Ke Qiao,Wang Lei,Lin Ziguo,Liu Hongzhi,Lou Jianying,Zheng Shuguo,Bi Xinyu,Wang Jianming,Guo Wei,Li Fuyu,Wang Jian,Zheng Yamin,Li Jingdong,Cheng Shi,Zhou Weiping,Liu Jingfeng,Zeng Yongyi
Abstract
Abstract
Background
Radical resection is still the most cost-effectiveness curative strategy for intrahepatic cholangiocarcinoma (ICC), but it remains controversial on the survival benefit of anatomic resection (AR). In this study, we sought to compare the oncologic outcomes between AR versus non-AR (NAR) as the primary treatment for early-stage ICC patients.
Methods
Data of ICC patients who underwent hepatectomy and staged at AJCC I were retrospectively collected from 12 hepatobiliary centers in China between Dec 2012 and Dec 2015. Propensity score matching (PSM) and stabilized inverse probability of treatment weighting (IPTW) analysis were performed to minimize the effect of potential confounders, and the perioperative and long-term outcomes between AR and NAR groups were compared.
Results
Two hundred seventy-eight ICC patients staged at AJCC I were eligible for this study, including 126 patients receiving AR and 152 patients receiving NAR. Compared to the NAR group, the AR group experienced more intraoperative blood loss before and after PSM or stabilized IPTW (all P > 0.05); AR group also experienced more intraoperative transfusion after stabilized IPTW (P > 0.05). In terms of disease-free survival (DFS) and overall survival (OS), no significant differences were observed between the two groups before and after PSM or stabilized IPTW (all P > 0.05). Multivariable Cox regression analyses found that AR was not an independent prognostic factor for either DFS or OS (all P > 0.05). Further analysis also showed that the survival benefit of AR was not found in any subgroup stratified by Child–Pugh grade (A or B), cirrhosis (presence or absence), tumor diameter (≤ 5 cm or > 5 cm) and pathological type (mass-forming or non-mass-forming) with all P > 0.05.
Conclusion
Surgical approach does not influence the prognosis of patients with stage I primary ICC, and NAR might be acceptable and oncological safety.
Funder
the Startup Fund for Scientific Research, Fujian Medical University, Fujian, P.R.C
Fujian Provincial Clinical Research Center for Hepatobiliary and Pancreatic Tumors, Fujian, P.R.C
the Key Clinical Specialty Discipline Construction Program of Fuzhou, Fujian, P.R.C
the National Natural Science Foundation of China, P.R.C
the Joint Funds for the Innovation of Science and Technology of Fujian province, Fujian, P.R.C
The Major Scientific Research Project for Middle and Young People funded by the Fujian Provincial Health Commission, Fujian, P.R.C
Publisher
Springer Science and Business Media LLC
Subject
Cancer Research,Genetics,Oncology
Cited by
1 articles.
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