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

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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.

Original languageEnglish
Pages (from-to)2549-2557
Number of pages9
JournalCancer Science
Volume109
Issue number8
DOIs
Publication statusPublished - Aug 1 2018

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Keywords

  • Cisplatin
  • drug therapy
  • gemcitabine
  • prognosis
  • sorafenib

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Kobayashi, S., Terashima, T., Shiba, S., Yoshida, Y., Yamada, I., Iwadou, S., Horiguchi, S., Takahashi, H., Suzuki, E., Moriguchi, M., Tsuji, K., Otsuka, T., Asagi, A., Kojima, Y., Takada, R., Morizane, C., Mizuno, N., Ikeda, M., Ueno, M., & Furuse, J. (2018). Multicenter retrospective analysis of systemic chemotherapy for unresectable combined hepatocellular and cholangiocarcinoma. Cancer Science, 109(8), 2549-2557. https://doi.org/10.1111/cas.13656