Abstract：
BACKGROUND: Over recent years, there has been a notable rise in the incidence of intrahepatic cholangiocarcinoma (iCCA), which presents a significant challenge in treatment due to its complex disease characteristics and prognosis. Notably, the identification of fibroblast growth factor receptor 2 (FGFR2) fusion/rearrangement, a potential oncogenic driver primarily observed in iCCA, raises questions about its impact on the prognostic outcomes of patients undergoing surgical intervention or other therapeutic approaches.
METHODS: A comprehensive search from inception to July 2023 was conducted across PubMed, Embase, Web of Science, and the Cochrane Library databases. The objective was to identify relevant publications comparing the prognosis of FGFR2 alterations and no FGFR2 alterations groups among patients with iCCA undergoing surgical resection or other systemic therapies. The primary outcome indicators, specifically Overall Survival (OS) and Disease-Free Survival (DFS), were estimated using Hazard Ratios (HRs) with 95% confidence intervals (CIs), and statistical significance was defined as p < .05. Study quality was assessed using the Newcastle-Ottawa Quality Assessment Scale. Statistical analyses were performed using Review Manager 5.4 software and Stata, version 12.0.
RESULTS: Six studies, involving 1314 patients (FGFR2 alterations group n = 173 and no FGFR2 alterations group n = 1141), were included in the meta-analysis. The analysis revealed that the FGFR2 alterations group exhibited a significantly better OS prognosis compared to the no FGFR2 alterations group, with a fixed-effects combined effect size HR = 1.31, 95%CI = 1.001-1.715, p = .049. Furthermore, meta-regression and subgroup analysis showed that the length of the follow-up period did not introduce heterogeneity into the results. This finding indicates the stability and reliability of the study outcomes.
CONCLUSIONS: The current study provides compelling evidence that FGFR2 alterations are frequently associated with improved survival outcomes for patients with iCCA undergoing surgical resection or other systemic treatments. Additionally, the study suggests that FGFR2 holds promise as a safe and dependable therapeutic target for managing metastatic, locally advanced or unresectable iCCA. This study offers a novel perspective in the realm of targeted therapy for iCCA, presenting a new and innovative approach to its treatment.
METHODS: A comprehensive search from inception to July 2023 was conducted across PubMed, Embase, Web of Science, and the Cochrane Library databases. The objective was to identify relevant publications comparing the prognosis of FGFR2 alterations and no FGFR2 alterations groups among patients with iCCA undergoing surgical resection or other systemic therapies. The primary outcome indicators, specifically Overall Survival (OS) and Disease-Free Survival (DFS), were estimated using Hazard Ratios (HRs) with 95% confidence intervals (CIs), and statistical significance was defined as p < .05. Study quality was assessed using the Newcastle-Ottawa Quality Assessment Scale. Statistical analyses were performed using Review Manager 5.4 software and Stata, version 12.0.
RESULTS: Six studies, involving 1314 patients (FGFR2 alterations group n = 173 and no FGFR2 alterations group n = 1141), were included in the meta-analysis. The analysis revealed that the FGFR2 alterations group exhibited a significantly better OS prognosis compared to the no FGFR2 alterations group, with a fixed-effects combined effect size HR = 1.31, 95%CI = 1.001-1.715, p = .049. Furthermore, meta-regression and subgroup analysis showed that the length of the follow-up period did not introduce heterogeneity into the results. This finding indicates the stability and reliability of the study outcomes.
CONCLUSIONS: The current study provides compelling evidence that FGFR2 alterations are frequently associated with improved survival outcomes for patients with iCCA undergoing surgical resection or other systemic treatments. Additionally, the study suggests that FGFR2 holds promise as a safe and dependable therapeutic target for managing metastatic, locally advanced or unresectable iCCA. This study offers a novel perspective in the realm of targeted therapy for iCCA, presenting a new and innovative approach to its treatment.
摘要：
背景：近年来，肝内胆管癌（iCCA）的发病率显着上升，由于其复杂的疾病特征和预后，对治疗提出了重大挑战。值得注意的是,成纤维细胞生长因子受体2（FGFR2）融合/重排的鉴定，主要在iCCA中观察到的潜在致癌驱动因素，对其对接受手术干预或其他治疗方法的患者预后结果的影响提出了质疑.
方法：从开始到2023年7月，在PubMed进行了全面搜索，Embase,WebofScience,和Cochrane图书馆数据库.目的是确定相关出版物，比较接受手术切除或其他全身治疗的iCCA患者中FGFR2改变和无FGFR2改变组的预后。主要结果指标，特别是总生存率（OS）和无病生存率（DFS），使用具有95%置信区间(CI)的危险比率(HR)进行估计，统计学意义定义为p<0.05。使用纽卡斯尔-渥太华质量评估量表评估研究质量。使用ReviewManager5.4软件和Stata进行统计分析，版本12.0。
结果：六项研究，涉及1314例患者（FGFR2改变组n=173，无FGFR2改变组n=1141），纳入荟萃分析。分析显示，与无FGFR2改变组相比，FGFR2改变组表现出明显更好的OS预后。固定效应组合效应大小HR=1.31，95CI=1.001-1.715，p=0.049。此外，meta回归和亚组分析显示，随访期的长度没有将异质性引入结果。这一发现表明了研究结果的稳定性和可靠性。
结论：当前的研究提供了令人信服的证据，表明FGFR2改变通常与接受手术切除或其他全身治疗的iCCA患者的生存结局改善有关。此外,该研究表明，FGFR2有望成为治疗转移性肿瘤的安全可靠的治疗靶点，本地高级或不可切除的iCCA。这项研究为iCCA的靶向治疗领域提供了一个新的视角，提出了一种新的和创新的治疗方法。
方法：从开始到2023年7月，在PubMed进行了全面搜索，Embase,WebofScience,和Cochrane图书馆数据库.目的是确定相关出版物，比较接受手术切除或其他全身治疗的iCCA患者中FGFR2改变和无FGFR2改变组的预后。主要结果指标，特别是总生存率（OS）和无病生存率（DFS），使用具有95%置信区间(CI)的危险比率(HR)进行估计，统计学意义定义为p<0.05。使用纽卡斯尔-渥太华质量评估量表评估研究质量。使用ReviewManager5.4软件和Stata进行统计分析，版本12.0。
结果：六项研究，涉及1314例患者（FGFR2改变组n=173，无FGFR2改变组n=1141），纳入荟萃分析。分析显示，与无FGFR2改变组相比，FGFR2改变组表现出明显更好的OS预后。固定效应组合效应大小HR=1.31，95CI=1.001-1.715，p=0.049。此外，meta回归和亚组分析显示，随访期的长度没有将异质性引入结果。这一发现表明了研究结果的稳定性和可靠性。
结论：当前的研究提供了令人信服的证据，表明FGFR2改变通常与接受手术切除或其他全身治疗的iCCA患者的生存结局改善有关。此外,该研究表明，FGFR2有望成为治疗转移性肿瘤的安全可靠的治疗靶点，本地高级或不可切除的iCCA。这项研究为iCCA的靶向治疗领域提供了一个新的视角，提出了一种新的和创新的治疗方法。
