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Impact of adjuvant therapy on outcomes after curative-intent resection for distal cholangiocarcinoma.
- Source :
-
Journal of surgical oncology [J Surg Oncol] 2023 Mar; Vol. 127 (4), pp. 607-615. Date of Electronic Publication: 2022 Nov 17. - Publication Year :
- 2023
-
Abstract
- Background: The benefit of adjuvant therapy (AT) after curative resection of distal cholangiocarcinoma (DCC) remains unclear. The objective of the current study was to investigate the impact of AT on long-term survival of patients who underwent curative-intent resection for DCC.<br />Methods: Patients who underwent curative-intent resection for DCC between 2000 and 2020 were identified from a multi-institutional database. The primary outcomes included overall (OS) and recurrence-free survival (RFS).<br />Results: Among 245 patients, 150 (61.2%) patients received AT (chemotherapy alone: n = 43; chemo- and radiotherapy: n = 107) after surgical resection, whereas 95 (38.8%) patients underwent surgery only. Patients who received AT were younger, and more likely to have an advanced tumor with the presence of perineural invasion (PNI), lymph node metastasis (LNM), lymph-vascular invasion, and higher T categories (all p < 0.05). Overall, there was no difference in OS (median, surgery + AT 25.5 vs. surgery alone 24.5 months, p = 0.27) or RFS (median, surgery + AT 15.8 vs. surgery alone 18.9 months, p = 0.24) among patients who did versus did not receive AT. In contrast, AT was associated with improved long-term survival among patients with PNI (median OS, surgery + AT 25.9 vs. surgery alone 17.8 months, p = 0.03; median RFS, surgery + AT 15.9 vs. surgery alone 11.9 months, p = 0.04) and LNM (median, surgery + AT 20.0 vs. surgery alone 17.8 months, p = 0.03), but not among patients with no PNI or LNM (all p > 0.1).<br />Conclusions: AT was commonly utilized among patients with DCC. Patients with more advanced disease, including the presence of PNI or LNM, benefited the most from AT with improved long-term outcomes among this subset of patients.<br /> (© 2022 Wiley Periodicals LLC.)
Details
- Language :
- English
- ISSN :
- 1096-9098
- Volume :
- 127
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of surgical oncology
- Publication Type :
- Academic Journal
- Accession number :
- 36394450
- Full Text :
- https://doi.org/10.1002/jso.27146