Neoadjuvant chemotherapy is associated with improved survival in patients undergoing hepatic resection for intrahepatic cholangiocarcinoma

Thomas L. Sutton, Kevin G. Billingsley, Brett S. Walker, C. Kristian Enestvedt, Elizabeth N. Dewey, Susan L. Orloff, Skye C. Mayo

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The impact of neoadjuvant chemotherapy (NAC) on overall and recurrence-free survival (OS, RFS) in resectable intrahepatic cholangiocarcinoma (ICC) is poorly characterized. We sought to investigate the association of NAC with oncologic outcomes in ICC. Methods: We identified n = 52 patients with ICC undergoing hepatectomy from 2004 to 2017. Oncologic outcomes were analyzed using Kaplan-Meier and multivariate Cox proportional hazard modeling. Results: The median patient age was 64-years. NAC was administered in ten (19%) patients, most commonly with gemcitabine-cisplatin (n = 8, 80%). Median RFS and OS were 15 months. and 49 months, respectively. Controlling for stage and margins, NAC was independently associated with improved OS (HR 0.16, P = 0.01) but not RFS (HR 0.54, P = 0.27). NAC was not associated with major post-operative complications (P = 0.25) or R1 margins (P = 0.58). Conclusion: NAC in ICC may hold oncologic benefits beyond downstaging borderline resectable disease, such as identifying patients with favorable biology who are more likely to benefit from resection.

Original languageEnglish (US)
Pages (from-to)1182-1187
Number of pages6
JournalAmerican journal of surgery
Volume221
Issue number6
DOIs
StatePublished - Jun 2021

Keywords

  • BILCAP
  • Hepatectomy
  • Intrahepatic cholangiocarcinoma
  • Neoadjuvant chemotherapy
  • Resection

ASJC Scopus subject areas

  • Surgery

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