TY - JOUR
T1 - Impact of adjuvant chemotherapy on survival in patients with intrahepatic cholangiocarcinoma
T2 - a multi-institutional analysis
AU - Reames, Bradley N.
AU - Bagante, Fabio
AU - Ejaz, Aslam
AU - Spolverato, Gaya
AU - Ruzzenente, Andrea
AU - Weiss, Matthew
AU - Alexandrescu, Sorin
AU - Marques, Hugo P.
AU - Aldrighetti, Luca
AU - Maithel, Shishir K.
AU - Pulitano, Carlo
AU - Bauer, Todd W.
AU - Shen, Feng
AU - Poultsides, George A.
AU - Soubrane, Oliver
AU - Martel, Guillaume
AU - Koerkamp, Bas G.
AU - Guglielmi, Alfredo
AU - Itaru, Endo
AU - Pawlik, Timothy M.
N1 - Publisher Copyright:
© 2017 International Hepato-Pancreato-Biliary Association Inc.
PY - 2017/10
Y1 - 2017/10
N2 - Background The benefit of adjuvant chemotherapy for resected intrahepatic cholangiocarcinoma (ICC) is unclear. The aim of the current study was to investigate the impact of adjuvant chemotherapy on survival among patients undergoing resection of ICC using a multi-institutional database. Methods 1154 ICC patients undergoing curative-intent hepatectomy between 1990 and 2015 were identified from 14 institutions. Cox proportional hazard modeling was used to determine the impact of adjuvant chemotherapy on overall survival (OS). Results Following resection, 347 (30%) patients received adjuvant chemotherapy, most commonly a gemcitabine-based regimen (n = 184, 52%). Patients with T2/T3/T4 disease were more likely to receive adjuvant therapy compared with patients with T1a/T1b disease (OR 2.5, 95%CI 1.89–3.23; P < 0.001). Among patients who did and did not receive adjuvant therapy, patients with T2/T3/T4 tumors had a 5-year OS of 37% (95%CI 28.9–44.4) versus 30% (95%CI 23.8–35.6), respectively (p = 0.006). Similarly patients with N1 disease who received adjuvant chemotherapy tended to have improved 5-year OS (18.3%, 95%CI 9.0–30.1 vs. no adjuvant therapy 12%, 95%CI 3.9–24.4; P = 0.050). Conclusions While adjuvant chemotherapy did not influence the prognosis of all ICC patients following surgical resection, it was associated with a potential survival benefit in subgroups of patients at increased risk for recurrence, such as those with advanced tumors.
AB - Background The benefit of adjuvant chemotherapy for resected intrahepatic cholangiocarcinoma (ICC) is unclear. The aim of the current study was to investigate the impact of adjuvant chemotherapy on survival among patients undergoing resection of ICC using a multi-institutional database. Methods 1154 ICC patients undergoing curative-intent hepatectomy between 1990 and 2015 were identified from 14 institutions. Cox proportional hazard modeling was used to determine the impact of adjuvant chemotherapy on overall survival (OS). Results Following resection, 347 (30%) patients received adjuvant chemotherapy, most commonly a gemcitabine-based regimen (n = 184, 52%). Patients with T2/T3/T4 disease were more likely to receive adjuvant therapy compared with patients with T1a/T1b disease (OR 2.5, 95%CI 1.89–3.23; P < 0.001). Among patients who did and did not receive adjuvant therapy, patients with T2/T3/T4 tumors had a 5-year OS of 37% (95%CI 28.9–44.4) versus 30% (95%CI 23.8–35.6), respectively (p = 0.006). Similarly patients with N1 disease who received adjuvant chemotherapy tended to have improved 5-year OS (18.3%, 95%CI 9.0–30.1 vs. no adjuvant therapy 12%, 95%CI 3.9–24.4; P = 0.050). Conclusions While adjuvant chemotherapy did not influence the prognosis of all ICC patients following surgical resection, it was associated with a potential survival benefit in subgroups of patients at increased risk for recurrence, such as those with advanced tumors.
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U2 - 10.1016/j.hpb.2017.06.008
DO - 10.1016/j.hpb.2017.06.008
M3 - Article
C2 - 28728891
AN - SCOPUS:85024119852
VL - 19
SP - 901
EP - 909
JO - HPB
JF - HPB
SN - 1365-182X
IS - 10
ER -