FILAMIN-A EXPRESSION PREDICTS RECURRENCE OF MASS-FORMING CHOLANGIOCARCINOMA AFTER HEPATECTOMY
Martina Nebbia*, Matteo Donadon, Flavio Milana, Cristiana Soldani, Barbara Franceschini, MICHELA ANNA POLIDORO, Di Tommaso Luca, Lleo De Nalda Ana, Andrea Lania, Guido Torzilli
Department of Hepatobiliary and General Surgery, Humanitas Research Hospital & Humanitas University, Alessandria, Italy
Introduction
Recurrence of mass-forming cholangiocarcinoma (MFCCC) after hepatectomy is very high. A predictive marker of recurrence capable of personalizing follow-up and developing new targeted therapy would be beneficial. The overexpression of Filamin-A (FlnA), a cytoskeleton protein with scaffolding properties, has recently been associated with cell signalling, migration and adhesion in different tumors. The aim of this study was to test the expression of FlnA in a cohort of patients operated for MFCCC.
Methods
A retrospective cohort of patients who underwent hepatic resection for MFCCC at Humanitas Clinical and Research Center between January 2004 and December 2018 was analyzed. FlnA expression was measured by calculating its intensity score at immunohistochemistry on paraffin-embedded tumor tissue sections for each patient. Such expression was then correlated with prognostic parameter of disease-free survival (DFS) by using survival analyses.
Results
A total of 82 patients were considered. Median DFS in patients with low expression of FlnA was significantly increased in comparison with patients with high expression of FlnA (27 months vs. 10 months). Similarly, 5-year DFS was 30.8% vs. 10.9% (P=0.008). At the multivariate analysis number of tumor (HR=2.18; CI95% 1.98-3-21; P=0.004), tumor grade (HR=2.81; CI95% 1.77-5.12; P=0.001) and high expression of FlnA (HR=1.81; CI95% 0.98-2.31; P=.0.005) were found to be independently associated with worse DFS.
Conclusions
FlnA expression is associated with higher risk of recurrence of MFCCC after hepatectomy. This finding provides important insights that would help physicians to personalize follow-up strategies and develop targeted therapy.
Figure 1. Median DFS in patients with low expression of FlnA was significantly increased in comparison with patients with high expression of FlnA (27 months vs. 10 months, p=0.009).
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