Intrahepatic CC recurrence after resection
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The surgery dates for my group ranged from May 2001 to Sept. 2012 so all of my group would be in the Italian post 1999 group. Of the 25, 3 had neoadjuvant chemo before the resection and I don’t have information regarding if they had chemo after the resection. Of the others, 15 had adjuvant or systemic therapy, 6 had none, and 1 was not available.
My database at this time represents only 8% of the foundation’s membership. Considering that the total membership at this time is 2,339, the potential number of members falling into this classification could conceivably be over 300, although it probably won’t be that high since I have been concentrating so far, but not exclusively, on finding members with IHCC.
However, the paper by Olivier Farges, which discussed preliminary analysis of the AJCC 7th edition of TMN Staging for resectable IHCC, used a cohort of 163 patients and the median survival for the entire cohort was 36 months. His study started with 522 patients but excluded 217 of them because of no lymphadenectory, 63 because of no accurate pN staging, 63 because of no R0 resenction, and 16 for other causes. Of the 25 in my database, 15 are R0, 5 appear to be R0, 1 is R1, 2 are R2, and 1 is unknown. So the 25 member cohort should have a lower survival rate than the Farges paper. It’s not, but the 37.4 months I got was pretty close to the 36 months that Farges got.
Bruce
Hi,
In my opinion, it all comes down to timing , location and the will of survival for this disease.
God bless.Hi Bruce,
Your sample includes 25 patients. Italian sample was 72 patients. These are small samples. The profile of the two samples — demographics, staging, treatment protocols, performance status — can be very different. That would explain the discrepancy between your result and Italian result.
When I researched the survival statistics for my wife’s case, I saw a *wide* range of numbers. From very grim to quite encouraging. Most papers I looked at were single hospital studies with small samples. If I recall correctly, Japanese reports had the best results.
Eli
There is much to read in to this study, but I come away with the fact that patients received adjuvant chemotherapy and consequently faired better than the group prior to 1999 who had not received treatments.
Hugs,
MarionI figured out how to calculate the median survival time using all 25 patients with IHCC who have had resections, by substituting last post date for follow-up date. The final result increased the median survival time from 33.3 months to 37.4 months, still a lot lower than the Italians got.
Bruce
I just looked at the abstract and saw that the median survival time for all 72 patients was 57.1 months, which seemed high to me. My database of foundation members has 25 patients with IHCC who have had resections. I have surgery dates and death dates for nine of those, and for this group the median survival time from surgery is 33.3 months.
Usually these studies use an algorithm for calculating median survival times which include patients with a last follow-up before the end of the study, so the authors don’t know if the patient has died or not. I could probably do that with the data I have using the time between surgery and the last post, but I’ll have to explore this further.
Other than that, what do the Italians know that the Americans don’t know?
Bruce
In researching this topic, I ran across the abstract of an Italian study regarding survival after recurrence of intrahepatic CC. I haven’t been able to obtain the entire study but, based on the abstract, the results seem more encouraging than most of what I have read. I tried to show it to my husband’s oncologist but he really wasn’t interested. I wondered whether any of you were familiar with this study and what you thought of it?
http://www.ncbi.nlm.nih.gov/pubmed/20531002
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