Assessment of the Outcomes of Intrahepatic Cholangiocarcinoma After Ultrasound-Guided Percutaneous Microwave Ablation Ba
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CLINICAL INVESTIGATION
INTERVENTIONAL ONCOLOGY
Assessment of the Outcomes of Intrahepatic Cholangiocarcinoma After Ultrasound-Guided Percutaneous Microwave Ablation Based on Albumin–Bilirubin Grade Hongcai Yang1,2 • Zhigang Cheng2 • Zhiyu Han2 • Fangyi Liu2 • Xiaoling Yu2 Jie Yu2 • Ping Liang1,2
•
Received: 17 March 2020 / Accepted: 27 August 2020 Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2020
Abstract Objective To determine whether albumin–bilirubin (ALBI) grade could be used to predict the outcomes of patients with intrahepatic cholangiocarcinoma (ICC) who underwent ultrasound-guided percutaneous microwave ablation (MWA). Materials and Methods This retrospective study was approved by the institutional review board, and the requirement for informed consent was waived. We studied 52 treatment-naı¨ve patients with 74 ICC lesions according to the Milan criteria who subsequently underwent MWA from April 2011 to March 2018. Overall survival (OS) and recurrence-free survival (RFS) were compared in groups classified by Child–Pugh score and ALBI grade, which were statistically analyzed with the log-rank test. Cox proportional hazard regression analyses were used to determine the prognostic factors for survival in patients with ICC. Results The median follow-up time was 21.2 months (3.2–78.7 months). Seventeen patients died during this period. After MWA, the cumulative 1-, 3-, and 5-year OS rates were 87.4%, 51.4%, and 35.2%, respectively, and the cumulative 1-, 3-, and 5-year RFS rates were 68.9%, 56.9%, and 56.9%, respectively. The major complication
& Jie Yu [email protected] & Ping Liang [email protected] 1
School of Medicine, Nankai University, Tianjin 300071, China
2
Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China
rate was 3.8% (2/52). Stratified according to ALBI grade, the cumulative 1-, 3-, and 5-year OS rates were 95.5%, 72.4%, and 72.4% for patients with ALBI grade 1 and 62.5%, 40.6%, and 36.3% for patients with ALBI grade 2, respectively, showing a significant difference (P = 0.006). Multivariate analysis results showed that older age (hazard ratio [HR]: 1.67, 95% confidence interval [CI]: 1.11–2.82; P = 0.002), tumor size C 3 cm in diameter (HR: 11.33, CI: 2.24–34.52; P = 0.021) and ALBI grade (HR: 8.23, CI: 1.58–58.00; P = 0.004) may be predictors of poor OS. Conclusion ALBI grade was validated as a significant biomarker for predicting survival in ICC patients within the Milan criteria who underwent MWA. Keywords Albumin–bilirubin grade Microwave ablation Intrahepatic cholangiocarcinoma Overall survival Recurrence-free survival
Introduction Intrahepatic cholangiocarcinoma (ICC) is a subtype of cholangiocarcinoma (CCA) based on the anatomical location of the tumor [1]. As the second most common primary liver cancer after hepatocellular carcinoma (HCC), a vast majority of ICCs occur sporadically without any apparent cause [2, 3].
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