Shirono Tomotake, Niizeki Takashi, Iwamoto Hideki, Shimose Shigeo, Suzuki Hiroyuki, Kawaguchi Takumi, Kamachi Naoki, Noda Yu, Okamura Shusuke, Nakano Masahito, Kuromatu Ryoko, Koga Hironori, Torimura Takuji
Division of Gastroenterology, Department of Medicine, School of Medicine, Kurume University, Kurume 830-0011, Japan.
J Clin Med. 2021 Mar 2;10(5):987. doi: 10.3390/jcm10050987.
Prognosis of patients with intrahepatic cholangiocarcinoma (ICC) is unsatisfactory. Tumor, host, and treatment factors including hepatic arterial infusion chemotherapy (HAIC) are intricately involved in the progression of ICC. We aimed to identify profiles associated with disease control rate (DCR) and the prognosis of patients with unresectable ICC by decision tree analysis. We analyzed 31 consecutive patients with unresectable ICC (median age, 71 years; the male ratio was 58.1%). Stage IVB occupied 51.6% of patients, and 38.7% and 58.1% of patients were treated with gemcitabine plus cisplatin combination therapy and HAIC, respectively. Profiles associated with prognosis as well as DCR were investigated by decision tree analysis. The median survival time (MST) of the patients was 11.6 months, and the DCR was 70.9%. Multivariate correlation analysis showed that albumin levels and WBC levels were significantly correlated with survival time (albumin, ρ = 0.3572, = 0.0485; WBC, ρ = -0.4008, = 0.0280). In decision tree analysis, WBC level was selected as the initial split variable, and subjects with WBC levels of 6800/μL or less (45.1%) showed a long survival time (MST 476 days). We also demonstrated that the profile associated with the highest DCR was "less than 4.46 mg/dL of CRP levels and treatment with HAIC". We demonstrated a new prognostic profile for ICC patients, which consisted of WBC and CRP levels. Moreover, we demonstrated that HAIC was associated with better disease control in ICC patients with low CPR levels. Thus, these new profiles may be useful for the management of ICC patients.
肝内胆管癌（ICC）患者的预后并不理想。肿瘤、宿主以及包括肝动脉灌注化疗（HAIC）在内的治疗因素都与ICC的进展密切相关。我们旨在通过决策树分析确定与不可切除ICC患者的疾病控制率（DCR）和预后相关的特征。我们分析了31例连续的不可切除ICC患者（中位年龄71岁；男性比例为58.1%）。IVB期患者占51.6%，分别有38.7%和58.1%的患者接受了吉西他滨联合顺铂化疗和HAIC治疗。通过决策树分析研究与预后以及DCR相关的特征。患者的中位生存时间（MST）为11.6个月，DCR为70.9%。多变量相关性分析显示，白蛋白水平和白细胞水平与生存时间显著相关（白蛋白，ρ = 0.3572，P = 0.0485；白细胞，ρ = -0.4008，P = 0.0280）。在决策树分析中，白细胞水平被选为初始分割变量，白细胞水平≤6800/μL的受试者（45.1%）显示出较长的生存时间（MST 476天）。我们还证明，与最高DCR相关的特征是“CRP水平低于4.46 mg/dL且接受HAIC治疗”。我们展示了一种针对ICC患者的新的预后特征，其由白细胞和CRP水平组成。此外，我们证明HAIC与CPR水平低的ICC患者更好的疾病控制相关。因此，这些新特征可能有助于ICC患者的管理。
