The role of adjuvant therapy after R0 resection for patients with intrahepatic and perihilar cholangiocarcinomas
- Kim, Young Saing; Oh, Sung Yong; Go, Se-Il; Kang, Jung-Hun; Park, Inkeun; Song, Haa-Na; Ji, Jun Ho; Hwang, In Gyu; Jang, Joung-Soon
- Issue Date
- Adjuvant therapy; Chemotherapy; Chemoradiotherapy; Radiotherapy; Intrahepatic cholangiocarcinoma; Perihilar cholangiocarcinoma; R0 resection
- CANCER CHEMOTHERAPY AND PHARMACOLOGY, v.79, no.1, pp.99 - 106
- Journal Title
- CANCER CHEMOTHERAPY AND PHARMACOLOGY
- Start Page
- End Page
- There is still debated regarding the optimal treatment strategy for cholangiocarcinoma (CC) after curative resection. The aim of this study was to analyze the role of adjuvant therapy in R0-resected intrahepatic and perihilar CCs. We retrospectively reviewed the patients who underwent R0 resection for intrahepatic and perihilar CCs between January 2001 and December 2013 at six tertiary medical centers; adjuvant therapy consisted of chemotherapy (CT), chemoradiotherapy (CRT), or radiotherapy (RT). The outcomes of our study were recurrence-free survival (RFS) and overall survival (OS). We included a total of 137 consecutive patients in the analysis; 58.4% of them had intrahepatic CCs, and 25.5% had lymph node (LN) involvement. Seventy-three patients (53.3%) had received adjuvant therapy (CT, CRT, RT: 48, 13, 12, respectively), and most patients who had received adjuvant therapy had stage III or IVA, T3 or 4 tumors, and positive LNs. Multivariable analysis identified positive LN [hazard ratio (HR) 3.47; P < 0.001] and high baseline CA 19-9 level (HR 1.82; P = 0.027) as predictors of decreased OS. The effects of adjuvant therapy varied according to the treatment modality; adjuvant CRT showed significantly longer RFS than surgery only (HR 0.44; P = 0.036), with a nonsignificant trend for better OS (HR 0.46; P = 0.115). Adjuvant CT and RT were not associated with a survival advantage in R0-resected intrahepatic and perihilar CCs. CRT appears to be appropriate treatment after complete resection.
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- College of Medicine > Department of Medicine > Journal Articles
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