4 results on '"Zhang, Xu-Feng"'
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2. Proposed modification of the eighth edition of the AJCC staging system for intrahepatic cholangiocarcinoma.
- Author
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Zhang XF, Xue F, He J, Alexandrescu S, Marques HP, Aldrighetti L, Maithel SK, Pulitano C, Bauer TW, Shen F, Poultsides GA, Soubrane O, Martel G, Koerkamp BG, Itaru E, Lv Y, and Pawlik TM
- Subjects
- Bile Ducts, Intrahepatic pathology, Humans, Neoplasm Staging, Prognosis, Bile Duct Neoplasms pathology, Bile Duct Neoplasms surgery, Cholangiocarcinoma pathology, Cholangiocarcinoma surgery
- Abstract
Background: To improve the prognostic accuracy of the 8th edition of the American Joint Committee on Cancer (AJCC) staging system for intrahepatic cholangiocarcinoma (ICC) with establishment and validation of a modified TNM (mTNM) staging system., Methods: Data on patients who underwent curative-intent resection for ICC was collected from 15 high-volume centers worldwide (n = 643). An external validation dataset was obtained from the SEER registry (n = 797). The mTNM staging system was proposed by redefining T categories, and incorporating the recently proposed N status as N0 (no lymph node metastasis [LNM]), N1 (1-2 LNM) and N2 (≥3 LNM)., Results: The 8th AJCC TNM staging system failed to stratify overall survival (OS) of stage II versus IIIA, stage IIIB versus IV, as well as overall stage III versus IV among all patients from the two databases, as well as stage I versus II, and stage III versus III among patients who had ≥6 LNs examined. There was a monotonic decrement in survival based on the proposed mTNM staging classification among patients derived from both the multi-institutional (Median OS, stage I 69.8 vs. II 37.1 vs. III 18.9 vs. IV 16.4 months, all p < 0.05), and SEER (Median OS, stage I 87.0 vs. II 29.3 vs. III 17.7 vs. IV 14.2 months, all p < 0.05) datasets, which was also verified among patients who had ≥6 lymph node harvested from both databases., Conclusion: The modified TNM staging system for ICC using the new T and N definitions provided an improved means to stratify patients relative to long-term OS versus the 8th AJCC staging., (Copyright © 2021 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2021
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3. Tumor Burden Dictates Prognosis Among Patients Undergoing Resection of Intrahepatic Cholangiocarcinoma
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Dimitrios Moris, J. Madison Hyer, Kazunari Sasaki, Timothy M. Pawlik, Alfredo Guglielmi, Todd W. Bauer, Anghela Z. Paredes, Diamantis I. Tsilimigras, Itaru Endo, Olivier Soubrane, Shishir K. Maithel, George A. Poultsides, Carlo Pulitano, Kota Sahara, Federico Aucejo, Hugo Marques, Luca Aldrighetti, Sorin Alexandrescu, Bas Groot Koerkamp, Guillaume Martel, Matthew J. Weiss, Xu-Feng Zhang, Feng Shen, Tsilimigras, Diamantis I, Hyer, J Madison, Paredes, Anghela Z, Moris, Dimitrio, Sahara, Kota, Guglielmi, Alfredo, Aldrighetti, Luca, Weiss, Matthew, Bauer, Todd W, Alexandrescu, Sorin, Poultsides, George A, Maithel, Shishir K, Marques, Hugo P, Martel, Guillaume, Pulitano, Carlo, Shen, Feng, Soubrane, Olivier, Koerkamp, Bas Groot, Endo, Itaru, Sasaki, Kazunari, Aucejo, Federico, Zhang, Xu-Feng, Pawlik, Timothy M, and Surgery
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medicine.medical_specialty ,Adjuvant chemotherapy ,medicine.medical_treatment ,030230 surgery ,Gastroenterology ,Resection ,Cholangiocarcinoma ,03 medical and health sciences ,0302 clinical medicine ,Chemothearpy ,Surgical oncology ,Internal medicine ,Medicine ,Hepatectomy ,Humans ,Chemotherapy ,Intrahepatic Cholangiocarcinoma ,Survival analysis ,Adjuvant ,Tumor ,business.industry ,medicine.disease ,Prognosis ,HCC CHBPT ,Tumor Burden ,Oncology ,Bile Duct Neoplasms ,Chemotherapy, Adjuvant ,030220 oncology & carcinogenesis ,Hepatocellular carcinoma ,Cohort ,Surgery ,business - Abstract
Introduction: While tumor burden (TB) has been associated with outcomes among patients with hepatocellular carcinoma, the role of overall TB in intrahepatic cholangiocarcinoma (ICC) remains poorly defined. Methods: Patients undergoing curative-intent resection of ICC between 2000 and 2017 were identified from a multi-institutional database. The impact of TB on overall (OS) and disease-free survival (DFS) was evaluated in the multi-institutional database and validated externally. Results: Among 1101 patients who underwent curative-intent resection of ICC, 624 (56.7%) had low TB, 346 (31.4%) medium TB, and 131 (11.9%) high TB. OS incrementally worsened with higher TB (5-year OS; low TB: 48.3% vs medium TB: 29.8% vs high TB: 17.3%, p < 0.001). Similarly, patients with low TB had better DFS compared with medium and high TB patients (5-year DFS: 38.3% vs 18.7% vs 6.9%, p < 0.001). On multivariable analysis, TB was independently associated with OS (medium TB: HR = 1.40, 95% CI 1.14-1.71; high TB: HR = 1.89, 95% CI 1.46-2.45) and DFS (medium TB, HR = 1.61, 95% CI 1.33-1.96; high TB: HR = 2.03, 95% CI 1.56-2.64). Survival analysis revealed an excellent prognostic discrimination using the TB among the external validation cohort (3-year OS; low TB: 44.8%, medium TB: 29.3%; high TB: 23.3%, p = 0.03; 3-year DFS: low TB: 32.7%, medium TB: 10.7%; high TB: 0%, p < 0.001). While neoadjuvant chemotherapy was not associated with survival across the TB groups, receipt of adjuvant chemotherapy was associated with increased survival among patients with high TB (5-year OS: 24.4% vs 13.4%, p = 0.02). Conclusion: Overall TB dictated prognosis among patients with resectable ICC. TB may be used as a tool to help guide post-resection treatment strategies. info:eu-repo/semantics/publishedVersion
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- 2021
4. Prognostic impact of perineural invasion in intrahepatic cholangiocarcinoma: multicentre study
- Author
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Tao Wei, Xu-Feng Zhang, Jin He, Irinel Popescu, Hugo P. Marques, Luca Aldrighetti, Shishir K. Maithel, Carlo Pulitano, Todd W. Bauer, Feng Shen, George A. Poultsides, Oliver Soubrane, Guillaume Martel, Bas Groot Koerkamp, Endo Itaru, Yi Lv, Timothy M. Pawlik, Surgery, Wei, Tao, Zhang, Xu-Feng, He, Jin, Popescu, Irinel, Marques, Hugo P, Aldrighetti, Luca, Maithel, Shishir K, Pulitano, Carlo, Bauer, Todd W, Shen, Feng, Poultsides, George A, Soubrane, Oliver, Martel, Guillaume, Koerkamp, Bas Groot, Itaru, Endo, Lv, Yi, and Pawlik, Timothy M
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Cholangiocarcinoma ,Survival Rate ,Bile Ducts, Intrahepatic ,Bile Duct Neoplasms ,Humans ,Surgery ,Neoplasm Invasiveness ,Neoplasm Recurrence, Local ,Prognosis ,Retrospective Studies - Abstract
Background The aim of this study was to investigate the prognostic impact of perineural invasion (PNI) on tumour recurrence and survival among patients with resected intrahepatic cholangiocarcinoma (ICC). Methods This was a multicentre, retrospective study of patients who underwent resection with curative intent for ICC between 2000 and 2017. The relationship between PNI, clinicopathological characteristics, and long-term survival was analysed in the overall cohort and the subset of patients with early-stage ICC. Results Among 1095 patients who underwent resection of ICC, PNI was present in 239 (21.8 per cent). In univariable analysis, PNI was associated with worse disease-free survival (DFS) (median 13.2 versus 16.1 months for patients with and without PNI respectively; P = 0.038) and overall survival (OS) (26.4 versus 41.5 months; P < 0.001). In multivariable analysis, PNI was an independent risk factor associated with reduced DFS (hazard ratio (HR) 1.56, 95 per cent c.i. 1.06 to 2.13; P = 0.019) and OS (HR 1.74, 1.16 to 2.60; P = 0.007). In subgroup analysis of patients with early-stage disease (AJCC T1–2, 981 patients; or N0, 249 patients), PNI remained associated with worse DFS (T1–2: median 13.7 versus 16.6 months in patients with and without PNI respectively, P = 0.019; N0: 11.7 versus 17.5 months, P = 0.022) and OS (T1–2: 28.5 versus 45.7 months, P < 0.001; N0: 34.9 versus 47.5 months, P = 0.036). Conclusion PNI is a strong independent predictor of tumour recurrence and long-term survival following resection of ICC with curative intent, even among patients with early-stage disease. The presence of PNI should be assessed routinely.
- Published
- 2021
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