The effect of trans arterial chemoembolization in the management of intrahepatic cholangiocarcinoma. A systematic review and meta-analysis |
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| Institution: | 1. Department of Upper Gastrointestinal Surgery, University Hospitals Birmingham NHS Foundation Trust, UK;2. Institute of Immunology and Immunotherapy, University of Birmingham, UK;3. Institute of Cancer and Genomic Science, University of Birmingham, UK;4. Department of Oncology, University Hospitals Birmingham NHS Foundation Trust, UK;5. Department of Pathology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK;6. Department of Pathology, San Bortolo Hospital, Vicenza, Italy;1. Division of Colorectal Surgery, Department of Surgical Oncology, Tata Memorial Hospital and Homi Bhabha National Institute, Mumbai, Maharashtra, 400012, India;2. Department Radiodiagnosis, Tata Memorial Hospital and Homi Bhabha National Institute, Mumbai, Maharashtra, 400012, India;3. Department of Medical Oncology, Tata Memorial Hospital and Homi Bhabha National Institute, Mumbai, Maharashtra, 400012, India;1. Washington Cancer Institute, Program in Peritoneal Surface Malignancy Washington, DC, USA;2. Westat, Rockville, MD, USA;1. Second Department of Surgery, School of Medicine, Wakayama Medical University, Japan;2. Department of Pathology, Japanese Red Cross Kyoto Daiichi Hospital, Japan;1. Sarcoma, Melanoma and Rare Tumors Surgery Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy;2. Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy;3. Business Controlling Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy;1. Department of Nuclear Medicine, Tata Memorial Hospital and Homi Bhabha National Institute, Parel, Mumbai, Maharashtra, 400012, India;2. Division of Colorectal Surgery, Department of Surgical Oncology, Tata Memorial Hospital and Homi Bhabha National Institute, Mumbai, Maharashtra, 400012, India;3. Department of Medical Gastroenterology, Tata Memorial Hospital and Homi Bhabha National Institute, Mumbai, Maharashtra, 400012, India;4. Department of Radiation Oncology, Tata Memorial, Hospital and Homi Bhabha National Institute, Parel, Mumbai, Maharashtra, 400012, India |
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| Abstract: | BackgroundA comprehensive re-evaluation on the role of trans-arterial chemoembolization (TACE) in patients with intrahepatic cholangiocarcinoma.MethodsA thorough database searching was performed in PubMed, EMBASE, and the Cochrane Library. Eligible studies were restricted to comparative studies between TACE and non-TACE cohorts. RevMan5.3 software and Stata 13.0 software were used for statistical analyses. The primary endpoint of our study was long-term survival.ResultsA total of 11 studies with 2036 patients were finally identified. Pooled results revealed that patients receiving TACE had a significantly better overall survival (OS) versus those without TACE (P < 0.05). Subgroup analyses were performed according to different types of TACE. Prophylactic post-surgical TACE (PPTACE) was associated with a significantly better OS versus those without PPTACE (P < 0.05). Palliative TACE (PTACE) also achieved a significantly better OS compared with those with supportive treatment (ST) only (P < 0.00001). However, TACE had no impact on disease-free survival (P = 0.87) and was less effective than surgical resection (P = 0.003).ConclusionPPTACE has a remarkable impact on OS versus those with surgical resections only and should be regularly performed. Regarding patients with unresectable disease, apart from conventional ST, adjuvant PTACE is also recommended. Upcoming prospective randomized controlled trials are warranted for further validation. |
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| Keywords: | Intrahepatic cholangiocarcinoma Trans arterial chemoembolization Transcatheter arterial chemoembolization Transcatheter hepatic arterial chemoembolization Prognosis |
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