<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT04506281</url>
  </required_header>
  <id_info>
    <org_study_id>zs-ICC-neoadjuvant</org_study_id>
    <nct_id>NCT04506281</nct_id>
  </id_info>
  <brief_title>PD1 Antibody (Toripalimab), GEMOX and Lenvatinib Neoadjuvant Treatment for Resectable Intrahepatic Cholangiocarcinoma With High-risk Recurrence Factors</brief_title>
  <official_title>A Randomized Controlled, Multicenter, Open-label, Phase II Clinical Study of PD1 Antibody (Toripalimab) Combined With GEMOX Chemotherapy and Lenvatinib Neoadjuvant Treatment for Resectable Intrahepatic Cholangiocarcinoma With High-risk Recurrence Factors</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>Shanghai Zhongshan Hospital</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
    <collaborator>
      <agency>Xuhui Central Hospital, Shanghai</agency>
      <agency_class>Other</agency_class>
    </collaborator>
    <collaborator>
      <agency>Minhang Hospital, Fudan University</agency>
      <agency_class>Other</agency_class>
    </collaborator>
    <collaborator>
      <agency>Shanghai Jinshan Hospital</agency>
      <agency_class>Other</agency_class>
    </collaborator>
    <collaborator>
      <agency>Shenzhen University General Hospital</agency>
      <agency_class>Other</agency_class>
    </collaborator>
  </sponsors>
  <source>Shanghai Zhongshan Hospital</source>
  <oversight_info>
    <has_dmc>No</has_dmc>
    <is_fda_regulated_drug>No</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
  </oversight_info>
  <brief_summary>
    <textblock>
      A randomized controlled, multi-center, open, phase II clinical study is designed to target&#xD;
      patients with resectable intrahepatic cholangiocarcinoma with high-risk recurrence factors&#xD;
      which has extremely low postoperative recurrence-free survival. In this study, we aim to&#xD;
      compare the prognosis in intrahepatic cholangiocarcinoma between Toripalimab combined with&#xD;
      Lenvatinib and GEMOX neoadjuvant treatment and the current clinical surgical treatment&#xD;
      (traditional group).&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      Intrahepatic cholangiocarcinoma (ICC) is a malignant tumor of biliary epithelial cells that&#xD;
      originates from the branches of the intrahepatic bile duct at the second level and above. Its&#xD;
      incidence accounts for about 15%-20% of primary liver malignancies, showing a gradually&#xD;
      increasing trend. Surgical resection is currently the main method for the treatment of ICC.&#xD;
      The data of a large number of ICC cases show that even radical resection (R0) patients have&#xD;
      an average survival of only 18.3 months, while for palliative resection patients, the average&#xD;
      survival is only 6.6 months, and laparotomy patients only 5.6 months. Retrospective studies&#xD;
      reported that positive resection margins, lymph node metastasis, lymphatic vessel invasion,&#xD;
      nerve bundle invasion, preoperative CA199&gt;200U/ml, multiple tumor nodules, and&#xD;
      differentiation are the main factors affecting the survival of ICC patients after surgery.&#xD;
      How to improve the surgical results of ICC patients, especially those with high-risk factors&#xD;
      for postoperative recurrence, is an important way to improve the overall survival of ICC.&#xD;
      Neoadjuvant therapy refers to some treatments taken before surgery for newly treated tumor&#xD;
      patients who have not found distant metastasis, including chemotherapy, radiotherapy,&#xD;
      targeted therapy, etc., to reduce tumors, reduce tumor stages, and reduce postoperative&#xD;
      recurrence rate, prolonging survival time. Our previous study using Toripalimab combined with&#xD;
      Lenvatinib and Gemox chemotherapy in the first-line treatment of unresectable advanced&#xD;
      cholangiocarcinoma (NCT03951597,2020ESMO) showed that the ORR was 80% and the DCR reached&#xD;
      93.3%, of which 1 case was CR, 23 cases were PR, and 2 cases were successfully treated with&#xD;
      radical resection after downstage. And the adverse reactions are controllable. These data&#xD;
      suggest that Toripalimab combined with Lenvatinib and Gemox chemotherapy may be an ideal&#xD;
      neoadjuvant treatment for patients with resectable intrahepatic cholangiocarcinoma with&#xD;
      high-risk recurrence factors, needing more investigation.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Unknown status</overall_status>
  <last_known_status>Recruiting</last_known_status>
  <start_date type="Anticipated">August 10, 2020</start_date>
  <completion_date type="Anticipated">August 2023</completion_date>
  <primary_completion_date type="Anticipated">August 2021</primary_completion_date>
  <phase>Phase 2</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>Randomized</allocation>
    <intervention_model>Parallel Assignment</intervention_model>
    <primary_purpose>Treatment</primary_purpose>
    <masking>None (Open Label)</masking>
  </study_design_info>
  <primary_outcome>
    <measure>Event-free survival</measure>
    <time_frame>18 months</time_frame>
    <description>From randomization to the occurrence of the following events: disease progression prevents radical surgery; local or distant recurrence; second primary tumor; death due to various causes.</description>
  </primary_outcome>
  <secondary_outcome>
    <measure>Overall survival</measure>
    <time_frame>24 months</time_frame>
    <description>the time period from the randomization of the patient to the death event due to any reason</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Objective response rate</measure>
    <time_frame>6 months</time_frame>
    <description>The proportion of patients whose tumor volume has decreased to a predetermined value</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Pathological remission rate</measure>
    <time_frame>6 months</time_frame>
    <description>the ratio of the estimated active tumor size divided by the tumor bed size</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Adverse events</measure>
    <time_frame>12 months</time_frame>
    <description>the severity of adverse events will be evaluated according to the NCI CTCAE 5.0 standard</description>
  </secondary_outcome>
  <number_of_arms>2</number_of_arms>
  <enrollment type="Anticipated">128</enrollment>
  <condition>Cholangiocarcinoma, Intrahepatic</condition>
  <arm_group>
    <arm_group_label>Neoadjuvant treatment</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>Gemox chemotherapy:&#xD;
Day1 Oxaliplatin 85mg/m2+ gemcitabine 1g/m2, Day 8 gemcitabine 1g/m2 Three weeks is a course of treatment, a total of 3 courses.&#xD;
Lenvatinib (8mg/d) for 9 weeks of continuous use.&#xD;
Toripalimab (240mg, once every 3 weeks), used 3 times. Evaluate the resectability of the operation within 2-4 weeks after the end of the neoadjuvant treatment course, and implement radical resection. All patients after resection use capecitabine 2500mg/m2 twice a day for 2 weeks, stopping for 1 week as a course of treatment, totaling 8 courses</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Traditional group</arm_group_label>
    <arm_group_type>No Intervention</arm_group_type>
    <description>No anti-tumor drug treatment before surgery. All patients undergoing resection use capecitabine 2500mg/m2 twice a day, stopping for 1 week as a course of treatment, totaling 8 courses.</description>
  </arm_group>
  <intervention>
    <intervention_type>Drug</intervention_type>
    <intervention_name>neoadjuvant treatment</intervention_name>
    <description>PD1 antibody (Toripalimab) combined with GEMOX chemotherapy and Lenvatinib neoadjuvant treatment</description>
    <arm_group_label>Neoadjuvant treatment</arm_group_label>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  1) Sign written informed consent 2) Male or female patients aged 18-70; 3) ECOG score&#xD;
             0 points, Child-Pugh rating A; 4) Clinically diagnosed as ICC as a potential entry,&#xD;
             the neoadjuvant group must be histopathologically diagnosed as intrahepatic&#xD;
             cholangiocarcinoma before neoadjuvant, and the traditional group must be&#xD;
             pathologically confirmed as intrahepatic cholangiocarcinoma after surgery; 5)&#xD;
             Resectable ICC patients with high risk factors for recurrence (tumor diameter&gt;5cm or&#xD;
             imaging vascular invasion, multiple tumor nodules or hilar lymph node metastasis or&#xD;
             preoperative CA199&gt;200U/ml); 6) The functional indicators of important organs meet the&#xD;
             following requirements&#xD;
&#xD;
               1. Neutrophils≥1.5*109/L; platelets≥90*109/L; hemoglobin≥9g/dl; serum&#xD;
                  albumin≥3.5g/dl;&#xD;
&#xD;
               2. Coagulation function: International standardization (prothrombin time) ratio&#xD;
                  (INR) &lt;1.2;&#xD;
&#xD;
               3. T3 and T4 do not exceed the normal upper and lower limits by 2 times;&#xD;
&#xD;
               4. Bilirubin ≤ 1.5 times the upper limit of normal; ALT and AST ≤ 3 times the upper&#xD;
                  limit of normal;&#xD;
&#xD;
               5. Serum creatinine ≤ 1.5 times the upper limit of normal, creatinine clearance ≥&#xD;
                  60ml/min; 7) The subject has at least 1 measurable liver disease (according to&#xD;
                  RECIST1.1); 8) For women who are not breastfeeding or pregnant, use contraception&#xD;
                  during treatment or 3 months after the end of treatment.&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  1) Pathological diagnosis of hepatocellular carcinoma, mixed hepatocellular carcinoma&#xD;
             and other non-biliary cell carcinoma malignant tumor components; 2) Patients who&#xD;
             relapse after surgery, have received PD1 antibody, PDL1 antibody or CTLA4 antibody,&#xD;
             lenvatinib, chemotherapy in the past; participated in other clinical trials 30 days&#xD;
             before screening; 3) Past or simultaneous suffering from other malignant tumors,&#xD;
             except for fully treated non-melanoma skin cancer, cervical carcinoma in situ and&#xD;
             thyroid papillary carcinoma; 4) Active tuberculosis infection. Patients with active&#xD;
             tuberculosis infection within 1 year before enrollment; a history of active&#xD;
             tuberculosis infection more than 1 year before enrollment, no formal anti-tuberculosis&#xD;
             treatment or tuberculosis is still active; 5) Suffer from active, known or suspected&#xD;
             autoimmune diseases. Subjects with hypothyroidism who only need hormone replacement&#xD;
             therapy and skin diseases without systemic therapy can be selected; 6) Past&#xD;
             interstitial lung disease, or (non-infectious) pneumonia and need oral or intravenous&#xD;
             steroid therapy; 7) Long-term use of systemic hormones (dose equivalent to &gt;10mg&#xD;
             prednisone/day) or any other form of immunosuppressive therapy is required. Subjects&#xD;
             using inhaled or topical corticosteroids can be selected; 8) Active infections that&#xD;
             require systemic treatment; 9) Human immunodeficiency virus (HIV, HIV1/2 antibody)&#xD;
             positive; 10) A history of psychotropic drug abuse, alcohol or drug abuse; 11)&#xD;
             Significant clinically significant bleeding symptoms or a clear tendency to appear&#xD;
             within 3 months before enrollment; 12) Suspected of being allergic to study drugs; 13)&#xD;
             Suffer from hypertension, and cannot be well controlled by antihypertensive medication&#xD;
             (systolic blood pressure ≥140mmHg or diastolic blood pressure ≥90mmHg); 14) After&#xD;
             antiviral therapy, HBvDNA&gt;104 copies/ml, HCV RNA&gt;1000; 15) Accompanied by ascites,&#xD;
             hepatic encephalopathy, Gilbert syndrome, sclerosing cholangitis, etc. Combined with&#xD;
             insufficiency of other organs, it is expected that they cannot accept general&#xD;
             anesthesia or hepatectomy; 16) Other factors judged by the investigator that may&#xD;
             affect the safety of the subject or the compliance of the trial. Such as serious&#xD;
             illnesses (including mental illness) that require combined treatment, serious&#xD;
             laboratory abnormalities, or other family or social factors.&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>18 Years</minimum_age>
    <maximum_age>70 Years</maximum_age>
    <healthy_volunteers>No</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Jia Fan, MD &amp; PhD</last_name>
    <role>Study Chair</role>
    <affiliation>Shanghai Zhongshan Hospital</affiliation>
  </overall_official>
  <overall_contact>
    <last_name>xiao-yong Huang, MD</last_name>
    <phone>+8615021519215</phone>
    <email>huang.xiaoyong@zs-hospital.sh.cn</email>
  </overall_contact>
  <overall_contact_backup>
    <last_name>Guo-ming Shi, MD</last_name>
    <phone>+8613916969578</phone>
    <email>shi.guoming@zs-hospital.sh.cn</email>
  </overall_contact_backup>
  <location>
    <facility>
      <name>Zhongshan hospital</name>
      <address>
        <city>Shanghai</city>
        <state>Shanghai</state>
        <zip>200032</zip>
        <country>China</country>
      </address>
    </facility>
    <status>Recruiting</status>
    <contact>
      <last_name>Xiao-yong Huang, MD</last_name>
      <phone>+8615021519215</phone>
      <email>huang.xiaoyong@zs-hospital.sh.cn</email>
    </contact>
    <contact_backup>
      <last_name>Guo-Ming Shi</last_name>
      <phone>+8613916969578</phone>
      <email>shi.guoming@zs-hospital.sh.cn</email>
    </contact_backup>
    <investigator>
      <last_name>Jia Fan, MD&amp;PhD</last_name>
      <role>Principal Investigator</role>
    </investigator>
  </location>
  <location_countries>
    <country>China</country>
  </location_countries>
  <results_reference>
    <citation>Shaib Y, El-Serag HB. The epidemiology of cholangiocarcinoma. Semin Liver Dis. 2004 May;24(2):115-25. doi: 10.1055/s-2004-828889.</citation>
    <PMID>15192785</PMID>
  </results_reference>
  <results_reference>
    <citation>Shen WF, Zhong W, Xu F, Kan T, Geng L, Xie F, Sui CJ, Yang JM. Clinicopathological and prognostic analysis of 429 patients with intrahepatic cholangiocarcinoma. World J Gastroenterol. 2009 Dec 21;15(47):5976-82. doi: 10.3748/wjg.15.5976.</citation>
    <PMID>20014463</PMID>
  </results_reference>
  <results_reference>
    <citation>Cho SY, Park SJ, Kim SH, Han SS, Kim YK, Lee KW, Lee SA, Hong EK, Lee WJ, Woo SM. Survival analysis of intrahepatic cholangiocarcinoma after resection. Ann Surg Oncol. 2010 Jul;17(7):1823-30. doi: 10.1245/s10434-010-0938-y. Epub 2010 Feb 18.</citation>
    <PMID>20165987</PMID>
  </results_reference>
  <results_reference>
    <citation>Fisher SB, Patel SH, Kooby DA, Weber S, Bloomston M, Cho C, Hatzaras I, Schmidt C, Winslow E, Staley CA 3rd, Maithel SK. Lymphovascular and perineural invasion as selection criteria for adjuvant therapy in intrahepatic cholangiocarcinoma: a multi-institution analysis. HPB (Oxford). 2012 Aug;14(8):514-22. doi: 10.1111/j.1477-2574.2012.00489.x. Epub 2012 May 22.</citation>
    <PMID>22762399</PMID>
  </results_reference>
  <results_reference>
    <citation>Yamashita Y, Taketomi A, Morita K, Fukuhara T, Ueda S, Sanefuji K, Iguchi T, Kayashima H, Sugimachi K, Maehara Y. The impact of surgical treatment and poor prognostic factors for patients with intrahepatic cholangiocarcinoma: retrospective analysis of 60 patients. Anticancer Res. 2008 Jul-Aug;28(4C):2353-9.</citation>
    <PMID>18751418</PMID>
  </results_reference>
  <verification_date>August 2020</verification_date>
  <study_first_submitted>August 7, 2020</study_first_submitted>
  <study_first_submitted_qc>August 7, 2020</study_first_submitted_qc>
  <study_first_posted type="Actual">August 10, 2020</study_first_posted>
  <last_update_submitted>August 7, 2020</last_update_submitted>
  <last_update_submitted_qc>August 7, 2020</last_update_submitted_qc>
  <last_update_posted type="Actual">August 10, 2020</last_update_posted>
  <responsible_party>
    <responsible_party_type>Sponsor</responsible_party_type>
  </responsible_party>
  <keyword>intrahepatic Cholangiocarcinoma</keyword>
  <keyword>Lenvatinib</keyword>
  <keyword>Gemox chemotherapy</keyword>
  <keyword>Programmed cell death protein 1 antibody</keyword>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Cholangiocarcinoma</mesh_term>
    <mesh_term>Recurrence</mesh_term>
  </condition_browse>
  <patient_data>
    <sharing_ipd>No</sharing_ipd>
  </patient_data>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT04506281
org study id: zs-ICC-neoadjuvant
nct id: NCT04506281
lead sponsor: 
collaborator: 
collaborator: 
collaborator: 
collaborator: 
has dmc: No
is fda regulated drug: No
is fda regulated device: No
A randomized controlled, multi-center, open, phase II clinical study is designed to target
      patients with resectable intrahepatic cholangiocarcinoma with high-risk recurrence factors
      which has extremely low postoperative recurrence-free survival. In this study, we aim to
      compare the prognosis in intrahepatic cholangiocarcinoma between Toripalimab combined with
      Lenvatinib and GEMOX neoadjuvant treatment and the current clinical surgical treatment
      (traditional group).
Intrahepatic cholangiocarcinoma (ICC) is a malignant tumor of biliary epithelial cells that
      originates from the branches of the intrahepatic bile duct at the second level and above. Its
      incidence accounts for about 15%-20% of primary liver malignancies, showing a gradually
      increasing trend. Surgical resection is currently the main method for the treatment of ICC.
      The data of a large number of ICC cases show that even radical resection (R0) patients have
      an average survival of only 18.3 months, while for palliative resection patients, the average
      survival is only 6.6 months, and laparotomy patients only 5.6 months. Retrospective studies
      reported that positive resection margins, lymph node metastasis, lymphatic vessel invasion,
      nerve bundle invasion, preoperative CA199>200U/ml, multiple tumor nodules, and
      differentiation are the main factors affecting the survival of ICC patients after surgery.
      How to improve the surgical results of ICC patients, especially those with high-risk factors
      for postoperative recurrence, is an important way to improve the overall survival of ICC.
      Neoadjuvant therapy refers to some treatments taken before surgery for newly treated tumor
      patients who have not found distant metastasis, including chemotherapy, radiotherapy,
      targeted therapy, etc., to reduce tumors, reduce tumor stages, and reduce postoperative
      recurrence rate, prolonging survival time. Our previous study using Toripalimab combined with
      Lenvatinib and Gemox chemotherapy in the first-line treatment of unresectable advanced
      cholangiocarcinoma (NCT03951597,2020ESMO) showed that the ORR was 80% and the DCR reached
      93.3%, of which 1 case was CR, 23 cases were PR, and 2 cases were successfully treated with
      radical resection after downstage. And the adverse reactions are controllable. These data
      suggest that Toripalimab combined with Lenvatinib and Gemox chemotherapy may be an ideal
      neoadjuvant treatment for patients with resectable intrahepatic cholangiocarcinoma with
      high-risk recurrence factors, needing more investigation.
allocation: Randomized
intervention model: Parallel Assignment
primary purpose: Treatment
masking: None (Open Label)
measure: Event-free survival
time frame: 18 months
description: From randomization to the occurrence of the following events: disease progression prevents radical surgery; local or distant recurrence; second primary tumor; death due to various causes.
measure: Overall survival
time frame: 24 months
description: the time period from the randomization of the patient to the death event due to any reason
measure: Objective response rate
time frame: 6 months
description: The proportion of patients whose tumor volume has decreased to a predetermined value
measure: Pathological remission rate
time frame: 6 months
description: the ratio of the estimated active tumor size divided by the tumor bed size
measure: Adverse events
time frame: 12 months
description: the severity of adverse events will be evaluated according to the NCI CTCAE 5.0 standard
arm group label: Neoadjuvant treatment
arm group type: Experimental
description: Gemox chemotherapy:
Day1 Oxaliplatin 85mg/m2+ gemcitabine 1g/m2, Day 8 gemcitabine 1g/m2 Three weeks is a course of treatment, a total of 3 courses.
Lenvatinib (8mg/d) for 9 weeks of continuous use.
Toripalimab (240mg, once every 3 weeks), used 3 times. Evaluate the resectability of the operation within 2-4 weeks after the end of the neoadjuvant treatment course, and implement radical resection. All patients after resection use capecitabine 2500mg/m2 twice a day for 2 weeks, stopping for 1 week as a course of treatment, totaling 8 courses
arm group label: Traditional group
arm group type: No Intervention
description: No anti-tumor drug treatment before surgery. All patients undergoing resection use capecitabine 2500mg/m2 twice a day, stopping for 1 week as a course of treatment, totaling 8 courses.
intervention type: Drug
intervention name: neoadjuvant treatment
description: PD1 antibody (Toripalimab) combined with GEMOX chemotherapy and Lenvatinib neoadjuvant treatment
arm group label: Neoadjuvant treatment
criteria: 
gender: All
minimum age: 18 Years
maximum age: 70 Years
healthy volunteers: No
last name: Jia Fan, MD & PhD
role: Study Chair
affiliation: Shanghai Zhongshan Hospital
last name: xiao-yong Huang, MD
phone: +8615021519215
email: huang.xiaoyong@zs-hospital.sh.cn
last name: Guo-ming Shi, MD
phone: +8613916969578
email: shi.guoming@zs-hospital.sh.cn
facility: 
status: Recruiting
contact: 
contact backup: 
investigator: 
country: China
citation: Shaib Y, El-Serag HB. The epidemiology of cholangiocarcinoma. Semin Liver Dis. 2004 May;24(2):115-25. doi: 10.1055/s-2004-828889.
PMID: 15192785
citation: Shen WF, Zhong W, Xu F, Kan T, Geng L, Xie F, Sui CJ, Yang JM. Clinicopathological and prognostic analysis of 429 patients with intrahepatic cholangiocarcinoma. World J Gastroenterol. 2009 Dec 21;15(47):5976-82. doi: 10.3748/wjg.15.5976.
PMID: 20014463
citation: Cho SY, Park SJ, Kim SH, Han SS, Kim YK, Lee KW, Lee SA, Hong EK, Lee WJ, Woo SM. Survival analysis of intrahepatic cholangiocarcinoma after resection. Ann Surg Oncol. 2010 Jul;17(7):1823-30. doi: 10.1245/s10434-010-0938-y. Epub 2010 Feb 18.
PMID: 20165987
citation: Fisher SB, Patel SH, Kooby DA, Weber S, Bloomston M, Cho C, Hatzaras I, Schmidt C, Winslow E, Staley CA 3rd, Maithel SK. Lymphovascular and perineural invasion as selection criteria for adjuvant therapy in intrahepatic cholangiocarcinoma: a multi-institution analysis. HPB (Oxford). 2012 Aug;14(8):514-22. doi: 10.1111/j.1477-2574.2012.00489.x. Epub 2012 May 22.
PMID: 22762399
citation: Yamashita Y, Taketomi A, Morita K, Fukuhara T, Ueda S, Sanefuji K, Iguchi T, Kayashima H, Sugimachi K, Maehara Y. The impact of surgical treatment and poor prognostic factors for patients with intrahepatic cholangiocarcinoma: retrospective analysis of 60 patients. Anticancer Res. 2008 Jul-Aug;28(4C):2353-9.
PMID: 18751418
responsible party type: Sponsor
mesh term: Cholangiocarcinoma
mesh term: Recurrence
sharing ipd: No