Scholarlink

Purpose <p>To determine the degree of tumor necrosis on pathology and clinical outcomes among intrahepatic cholangiocarcinoma (iCCA) patients who were treated with transarterial radioembolization (TARE) and the bridge or downstaged to surgery.</p> Methods <p>A single center retrospective review was performed to include consecutive patients who underwent TARE using glass microspheres and then subsequently underwent surgical resection or transplant. Baseline characteristics, dosimetry, radiologic response, histological tumor necrosis, and overall survival were evaluated. A total of 20 patients (F: M = 14:6; age: 57.3 ± 10.8 years) underwent TARE and then received resection (<i>n</i> = 15) or living-donor liver transplant (<i>n</i> = 5). A total of 23 selective TARE (two segments or less) were delivered, with a mean dose 301.7 ± 177.5, whereas 18 lobar (left or right hepatic artery) doses were delivered, with a mean dose of 150.3 ± 44.1&#xa0;Gy. Concurrent systemic therapy was administered in 15 patients.</p> Results <p>The mean time from the initial TARE to surgery was 7.1 ± 9.2 months. On pathology, complete tumor necrosis, &gt; 90% necrosis, and extensive tumor necrosis (&gt; 50%) were achieved in 1 (5.0%), 13 (65.0%), and 18 (90.0%) patients, respectively. The median survival time (MST) calculated from the time of surgery was 40.2 (95%CI: 15.3-not reached) months, with a 1-yr, 3-yr, and 5-yr OS of 88.2% (95CI: 60.6–96.9%), 57.8% (95%CI: 31.1–77.3%), and 19.8% (95%CI: 1.5–53.5%). From the time of initial TARE, the MST was 41.4 (95%CI:22.9-not reached) month, with a 1-yr, 3-yr, and 5-yr OS of 100%, 69.9% (95%CI: 42.0-86.3%), and 30.9% (95%CI: 9.1–56.3%). Whether the patient received concomitant systemic treatment was associated with extensive tumor necrosis on pathology (Odds Ratio: 16.0, 95%CI: 1.27-200.92, <i>p</i> = 0.032).</p> Conclusion <p>Based on tumor explant data, TARE can result in substantial tumor necrosis in the treatment of iCCA, although complete necrosis is uncommon. The addition of systemic therapy appears to be associated with a higher likelihood of achieving extensive tumor necrosis.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Intrahepatic cholangiocarcinoma treated with glass yttrium-90 radioembolization: A histopathologic study

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年7月2日

查看全文
  • Qian Yu,
  • Peizi Li,
  • Satvik Jain,
  • Abdul Khan,
  • Joseph Steiner,
  • Chih-Yi Liao,
  • Joseph Franses,
  • Anjana Pillai,
  • John Fung,
  • J Michael Millis,
  • Rakesh Navuluri,
  • Steven Zangan,
  • Brian Funaki,
  • John Hart,
  • Osman Ahmed,
  • Thuong Van Ha

摘要

Purpose

To determine the degree of tumor necrosis on pathology and clinical outcomes among intrahepatic cholangiocarcinoma (iCCA) patients who were treated with transarterial radioembolization (TARE) and the bridge or downstaged to surgery.

Methods

A single center retrospective review was performed to include consecutive patients who underwent TARE using glass microspheres and then subsequently underwent surgical resection or transplant. Baseline characteristics, dosimetry, radiologic response, histological tumor necrosis, and overall survival were evaluated. A total of 20 patients (F: M = 14:6; age: 57.3 ± 10.8 years) underwent TARE and then received resection (n = 15) or living-donor liver transplant (n = 5). A total of 23 selective TARE (two segments or less) were delivered, with a mean dose 301.7 ± 177.5, whereas 18 lobar (left or right hepatic artery) doses were delivered, with a mean dose of 150.3 ± 44.1 Gy. Concurrent systemic therapy was administered in 15 patients.

Results

The mean time from the initial TARE to surgery was 7.1 ± 9.2 months. On pathology, complete tumor necrosis, > 90% necrosis, and extensive tumor necrosis (> 50%) were achieved in 1 (5.0%), 13 (65.0%), and 18 (90.0%) patients, respectively. The median survival time (MST) calculated from the time of surgery was 40.2 (95%CI: 15.3-not reached) months, with a 1-yr, 3-yr, and 5-yr OS of 88.2% (95CI: 60.6–96.9%), 57.8% (95%CI: 31.1–77.3%), and 19.8% (95%CI: 1.5–53.5%). From the time of initial TARE, the MST was 41.4 (95%CI:22.9-not reached) month, with a 1-yr, 3-yr, and 5-yr OS of 100%, 69.9% (95%CI: 42.0-86.3%), and 30.9% (95%CI: 9.1–56.3%). Whether the patient received concomitant systemic treatment was associated with extensive tumor necrosis on pathology (Odds Ratio: 16.0, 95%CI: 1.27-200.92, p = 0.032).

Conclusion

Based on tumor explant data, TARE can result in substantial tumor necrosis in the treatment of iCCA, although complete necrosis is uncommon. The addition of systemic therapy appears to be associated with a higher likelihood of achieving extensive tumor necrosis.