14 results on '"Zhang, Xu-Feng"'
Search Results
2. Accuracy and Prognostic Impact of Nodal Status on Preoperative Imaging for Management of Pancreatic Neuroendocrine Tumors: A Multi-Institutional Study
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Zhang, Nan, He, Jin, Maithel, Shishir K., Poultsides, George, Rocha, Flavio, Weber, Sharon, Fields, Ryan, Idrees, Kamran, Cho, Cliff, Lv, Yi, Zhang, Xu-Feng, and Pawlik, Timothy M.
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- 2024
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3. Lymphadenectomy for Intrahepatic Cholangiocarcinoma: Has Nodal Evaluation Been Increasingly Adopted by Surgeons over Time?A National Database Analysis
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Zhang, Xu-Feng, Chen, Qinyu, Kimbrough, Charles W., Beal, Eliza W., Lv, Yi, Chakedis, Jeffery, Dillhoff, Mary, Schmidt, Carl, Cloyd, Jordan, and Pawlik, Timothy M.
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- 2018
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4. Impact of Preoperative Jaundice and Biliary Drainage on Short- and Long-term Outcomes among Patients with Gallbladder Cancer.
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Xiang, Jun-Xi, Maithel, Shishir K., Weber, Sharon M., Poultsides, George, Wolfgang, Christopher, Jin, Linda, Fields, Ryan C., Weiss, Matthew, Scoggins, Charles, Idrees, Kamron, Shen, Perry, Zhang, Xu-Feng, and Pawlik, Timothy M.
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GALLBLADDER cancer ,CANCER patients ,JAUNDICE ,PROGNOSIS ,TREATMENT effectiveness - Abstract
Objectives: To characterize the prognostic implication of jaundice and preoperative biliary drainage on postoperative outcomes among patients with gallbladder cancer (GBC) undergoing surgical resection.Methods: Patients who underwent surgical resection of GBC identified from a multicenter database between January 2000 and December 2019 were retrospectively analyzed. Data on clinical and pathological details, as well as short- and long-term overall survival (OS), were obtained and compared among patients with and without preoperative jaundice and biliary drainage.Results: Among 449 patients with GBC, median and 1-, 3-, and 5-year OS were 17.4 months, 63.7%, 28.4%, and 22.1%, respectively. Patients who presented with preoperative jaundice (n = 100, 22.3%) were more likely to have advanced disease, a lower incidence of R0 resection (29.0% vs. 69.1%, p < 0.001), as well as a higher incidence of postoperative liver failure (4% vs. 0, p = 0.002), and worse long-term survival versus patients without jaundice (median OS, 10.4 vs. 27.1 months, p < 0.001). Preoperative biliary drainage was performed for the majority of jaundiced patients (77.0%) and was associated with decreased risk of postoperative liver failure (1.3% vs. 13.0%, p = 0.041); preoperative biliary drainage failed to improve long-term survival (median OS, 10.2 months vs. 12.0 months, p = 0.679). On multivariable analysis, R0 resection (17.5 vs. 7.6 months, p < 0.001) and adjuvant therapy (15.6 vs. 6.6 months, p = 0.027) were associated with improved long-term survival among jaundiced patients.Conclusions: While preoperative biliary drainage of jaundiced GBC patients decreased the risk of postoperative liver failure, it did not impact long-term outcomes. Rather, preoperative jaundice was associated with a lower chance at R0 resection and worse long-term survival. [ABSTRACT FROM AUTHOR]- Published
- 2023
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5. Development and Validation of a Modified Eighth AJCC Staging System for Primary Pancreatic Neuroendocrine Tumors.
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Zhang, Xu-Feng, Xue, Feng, Wu, Zheng, Lopez-Aguiar, Alexandra G., Poultsides, George, Makris, Eleftherios, Rocha, Flavio, Kanji, Zaheer, Weber, Sharon, Fisher, Alexander, Fields, Ryan, Krasnick, Bradley A., Idrees, Kamran, Smith, Paula M., Cho, Cliff, Beems, Megan, Lyu, Yi, Maithel, Shishir K., and Pawlik, Timothy M.
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Objective: To improve the prognostic accuracy of the eighth edition of AJCC staging system for pNETs with establishment and validation of a new staging system. Background: Validation of the updated eighth AJCC staging system for pNETs has been limited and controversial. Methods: Data from the SEER registry (1975–2016) (n = 3303) and a multi-institutional database (2000–2016) (n = 825) was used as development and validation cohorts, respectively. A mTNM was proposed by maintaining the eighth AJCC T and M definitions, and the recently proposed N status as N0 (no LNM), N1 (1–3 LNM), and N2 (≥4 LNM), but adopting a new stage classification. Results: The eighth TNM staging system failed to stratify patients with stage I versus IIA, stage IIB versus IIIA, and overall stage I versus II relative to long-term OS in both database. There was a monotonic decrement in survival based on the proposed mTNM staging classification among patients derived from both the SEER (5-year OS, stage I 87.0% vs stage II 80.3% vs stage III 72.9% vs stage IV 57.2%, all P < 0.001), and multi-institutional (5-year OS, stage I 97.6% vs stage II 82.7% vs stage III 78.4% vs stage IV 50.0%, all P < 0.05) datasets. On multivariable analysis, mTNM staging remained strongly associated with prognosis, as the hazard of death incrementally increased with each stage among patients in the 2 cohorts. Conclusion: A mTNM pNETs clinical staging system using N0, N1, N2 nodal categories was better at stratifying patients relative to long-term OS than the eighth AJCC staging. [ABSTRACT FROM AUTHOR]
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- 2022
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6. Redefining Conditional Overall and Disease-Free Survival After Curative Resection for Intrahepatic Cholangiocarcinoma: a Multi-institutional, International Study of 1221 patients.
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Hu, Liang-Shuo, Zhang, Xu-Feng, Weiss, Matthew, 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, B. Groot, Itaru, Endo, Lv, Yi, and Pawlik, Timothy M.
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PROGRESSION-free survival , *CHOLANGIOCARCINOMA , *RESEARCH , *RESEARCH methodology , *CANCER relapse , *PROGNOSIS , *MEDICAL cooperation , *EVALUATION research , *COMPARATIVE studies , *LONGITUDINAL method , *HEPATECTOMY ,BILE duct tumors - Abstract
Objectives: To assess conditional survival (CS) according to recurrence status, as well as conditional disease-free survival (cDFS) among patients with intrahepatic cholangiocarcinoma (ICC).Methods: CS and cDFS were evaluated among ICC patients who underwent curative-intent resection for ICC by using a multi-institutional database. Five-year CS (CS5) at "x" years was calculated separately for patients who did and did not experience recurrence. The cDFS3 at "x" years was defined as the chance to be disease-free for an additional 3 years after not having experienced a recurrence for "x" years postoperatively.Results: Among 1221 patients, median OS was 36.8 months. While estimated actuarial OS decreased over time, CS5 increased as patients survived over longer periods of time and reached 93.9% at 4 years among 139 patients who did not experience a recurrence. Among the 725 (59.4%) patients who did experience a tumor recurrence, CS5 decreased to 17.7% the first postoperative year; however, CS5 subsequently increased to 79.7% for 81 patients who had survived 4 years after surgery. While actuarial DFS decreased from 54.6% at 1 year to 28.2% at 5 years, estimated cDFS3 following liver resection increased over time. Of note, patients with known risk factors for recurrence had even more marked improvements in cDFS3 over subsequent years versus patients without risk factors for recurrence.Conclusion: CS and cDFS changed over time according to the presence of disease-specific risk factors, as well as the presence of recurrence. [ABSTRACT FROM AUTHOR]- Published
- 2020
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7. Lymphadenectomy for Intrahepatic Cholangiocarcinoma: Has Nodal Evaluation Been Increasingly Adopted by Surgeons over Time?A National Database Analysis.
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Xu-Feng Zhang, Qinyu Chen, Kimbrough, Charles W., Beal, Eliza W., Yi Lv, Chakedis, Jeffery, Dillhoff, Mary, Schmidt, Carl, Cloyd, Jordan, Pawlik, Timothy M., Zhang, Xu-Feng, Chen, Qinyu, and Lv, Yi
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CHOLANGIOCARCINOMA ,LYMPHADENECTOMY ,LYMPH nodes ,PROGNOSIS ,SURGICAL excision ,BILE ducts ,COMPARATIVE studies ,REPORTING of diseases ,HEPATECTOMY ,LYMPH node surgery ,RESEARCH methodology ,MEDICAL cooperation ,METASTASIS ,RESEARCH ,TUMOR classification ,BILE duct tumors ,EVALUATION research - Abstract
Background: Surgical management of intrahepatic cholangiocarcinoma routinely includes resection of the hepatic parenchyma, yet the role of lymphadenectomy (LND) is more controversial. The objective of the current study was to define overall utilization, as well as temporal trends, in the utilization of LND among patients undergoing curative-intent hepatectomy for ICC using a nationwide database.Materials and Methods: One thousand four hundred ninety-six patients who underwent curative-intent resection for ICC were identified using the SEER database from 2000 to 2013. The utilization of LND was assessed over time and by geographic region. LND utilization and the incidence of lymph node metastasis (LNM) were evaluated relative to AJCC T categories.Results: At the time of surgery, slightly over one-half of patients (n = 784, 52.4%) had at least one LN evaluated. Specifically, 613 (41.0%) patients had 1-5 LNs evaluated, whereas 171 (11.4%) patients had ≥ 6 LNs evaluated. The proportion of patients who had at least one LN evaluated at the time of surgery did not change with time (2000-2004: 50.5% vs. 2005-2009: 52.0% vs. 2010-2013: 53.7%) (p = 0.636). In contrast, the proportion of patients who had ≥ 6 LNs examined did increase (2000-2004: 6.9% vs. 2005-2009: 10.6% vs. 2009-2013: 14.3%) (p = 0.003). The risk of LNM was higher among patients with advanced T category tumors (Referent T1; T2a: OR 4.2, 95% CI 2.0-8.8, p < 0.001; T2b: OR 2.4, 95% CI 1.1-4.9, p = 0.018; T3: OR 3.6, 95% CI 1.6-7.9, p = 0.001; T4: OR 2.2, 95% CI 1.0-4.9, p = 0.049). In addition, the portion of patients with LNM varied among the different T categories (T1, 23.2%, T2a, 55.3%, T2b, 42.0%, T3, 51.4%, and T4, 39.5%; p = 0.001).Conclusions: Utilization of LND in the surgical management of ICC across the USA remained relatively low and did not change over the last decade. Selective utilization of LND may be problematic as T-stage was not a reliable predictor of nodal status with almost a quarter of patients with early stage disease having LNM. [ABSTRACT FROM AUTHOR]- Published
- 2018
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8. Early Recurrence of Neuroendocrine Liver Metastasis After Curative Hepatectomy: Risk Factors, Prognosis, and Treatment.
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Zhang, Xu-Feng, Beal, Eliza, Chakedis, Jeffery, Lv, Yi, Bagante, Fabio, Aldrighetti, Luca, Poultsides, George, Bauer, Todd, Fields, Ryan, Maithel, Shishir, Marques, Hugo, Weiss, Matthew, Pawlik, Timothy, Beal, Eliza W, Poultsides, George A, Bauer, Todd W, Fields, Ryan C, Maithel, Shishir Kumar, Marques, Hugo P, and Pawlik, Timothy M
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NEUROENDOCRINE tumors , *CANCER relapse , *HEPATECTOMY , *SURGICAL excision , *LIVER metastasis , *PROGRESSION-free survival , *THERAPEUTICS , *TUMOR treatment , *LIVER tumors , *LONGITUDINAL method , *PROGNOSIS , *TIME , *GASTROINTESTINAL tumors - Abstract
Background: Early tumor recurrence after curative resection typically indicates a poor prognosis. The objective of the current study was to investigate the risk factors, treatment, and prognosis of early recurrence of neuroendocrine tumor (NET) liver metastasis (NELM) after hepatic resection.Methods: A total of 481 patients who underwent curative-intent resection for NELM were identified from a multi-institutional database. Data on clinicopathological characteristics, intraoperative details, and outcomes were documented. The optimal cutoff value to differentiate early and late recurrence was determined to be 3 years based on linear regression.Results: With a median follow-up of 60 months, 223 (46.4%) patients developed a recurrence, including 158 (70.9%) early and 65 (29.1%) late recurrences. On multivariable analysis, pancreatic NET, primary tumor lymph node metastasis, and a microscopic positive surgical margin were independent risk factors for early intrahepatic recurrence. While recurrence patterns and treatments were comparable among patients with early and late recurrences, early recurrence was associated with worse disease-specific survival than late recurrences (10-year NELM-specific survival, 44.5 vs 75.8%, p < 0.001). Among the 34 (21.5%) patients who underwent curative treatment for early recurrence, post-recurrence disease-specific survival was better than non-curatively treated patients (10-year NELM-specific survival, 54.2 vs 26.3%, p = 0.028), yet similar to patients with late recurrences treated with curative intent (10-year NELM-specific survival, 54.2 vs 37.4%, p = 0.519).Conclusions: Early recurrence after surgery for NELM was associated with the pancreatic type, primary lymph node metastasis, and extrahepatic disease. Re-treatment with curative intent prolonged survival after recurrence, and therefore, operative intervention even for early recurrences of NELM should be considered. [ABSTRACT FROM AUTHOR]- Published
- 2017
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9. Hepatocellular carcinoma in elderly: Clinical characteristics, treatments and outcomes compared with younger adults.
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Guo, Hui, Wu, Tao, Lu, Qiang, Dong, Jian, Ren, Yi-Fan, Nan, Ke-Jun, Lv, Yi, and Zhang, Xu-Feng
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LIVER cancer ,OLDER patients ,CANCER in young adults ,PROPENSITY score matching - Abstract
The number of elderly patients diagnosed with hepatocellular carcinoma (HCC) is expected to increase. The present study aims to evaluate the role of age on treatments and outcome of HCC patients. 1530 patients firstly diagnosed with HCC were retrospectively included and classified as older (≥65 years, n = 318, 21%) and younger patients (<65 years, n = 1212, 79%). The two groups were compared with clinical characteristics, tumor burden, Barcelona Clinics Liver Cancer (BCLC) stage, treatments and long-term prognosis. Elderly patients were more HCV infected, had more diabetes, poorer performance status, and were less aggressively treated. The proportion of HCC within BCLC stage 0-A, B or C was similar between the two groups, but elderly patients were more presented with BCLC stage D. The overall survival of older patients was poorer compared to younger patients before and after propensity score matching. However, elderly patients were less often effectively treated with surgery and loco-regional therapies across different BCLC stages. After stratified by BCLC stages or treatments, older patients showed comparable long-term outcome to younger patients. Performance status, BCLC stages and effective treatments, rather than age, was independent factors determining prognosis in the whole cohort and only elderly patients by multivariate analysis. In conclusion, older could have comparable survival to younger patients within the same tumor stage or after similar treatments. Thus, equally active treatments should be encouraged to elderly patients. [ABSTRACT FROM AUTHOR]
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- 2017
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10. Prognostic role of neutrophil-to-lymphocyte ratio in colorectal cancer: A systematic review and meta-analysis.
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Li, Mu‐Xing, Liu, Xue‐Min, Zhang, Xu‐Feng, Zhang, Jian‐Fei, Wang, Wan‐Li, Zhu, Ying, Dong, Jian, Cheng, Ji‐Wen, Liu, Zheng‐Wen, Ma, Le, and Lv, Yi
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The prognostic role of inflammation index like neutrophil-to-lymphocyte ratio (NLR) in colorectal cancer (CRC) remains controversial. We conduct a meta-analysis to determine the predictable value of NLR in the clinical outcome of CRC patients. The analysis was carried out based on the data from 16 studies (19 cohorts) to evaluate the association between NLR and overall survival (OS) and progression-free survival (PFS) in patients with CRC. In addition, the relationship between NLR and clinicopathological parameters was assessed. Hazard ratio (HR) or odds ratio (OR) with its 95% confidence interval (CI) was used as the effect size estimate. Our analysis results indicated that elevated pretreatment NLR predicted poorer OS (HR: 1.813, 95% CI: 1.499-2.193) and PFS (HR: 2.102, 95% CI: 1.554-2.843) in patients with CRC. Increased NLR is also significantly associated with the poorer differentiation of the tumor (OR: 1.574, 95% CI: 1.226-2.022) and higher carcino-embryonie antigen (CEA) level (OR: 1.493, 95% CI: 1.308-1.705). By these results, we conclude that NLR gains a prognostic value for patients with CRC. NLR should be monitored in CRC patients for rational stratification of the patients and adjusting the treatment strategy. [ABSTRACT FROM AUTHOR]
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- 2014
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11. Does the Sex-Determining Region on the Y Chromosome (SRY) Correlate with Gender Disparity in Liver Disease?
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Zhang, Xu-Feng and Lv, Yi
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LIVER disease treatment , *GENETIC sex determination , *LIVER cancer , *CANCER cells , *PROGRESSION-free survival , *PHENOTYPES , *PROGNOSIS - Published
- 2015
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12. Lower Education and Household Income Contribute to Advanced Disease, Less Treatment Received, and Poorer Prognosis in Hepatocellular Carcinoma.
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Zhang, Xu-Feng, Guo, Hui, and Lv, Yi
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LIVER cancer patients , *LIVER cancer , *INCOME , *SOCIOECONOMICS , *PROGNOSIS - Published
- 2017
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13. 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
14. Prognostic impact of perineural invasion in intrahepatic cholangiocarcinoma: multicentre study
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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.
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- 2021
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