Outcomes of adjuvant treatments for resectable intrahepatic cholangiocarcinoma: Chemotherapy alone, sequential chemoradiotherapy, or concurrent chemoradiotherapy

Yen Kuang Lin, Mao Chih Hsieh, Wei Wei Wang, Yi Chun Lin, Wei Wen Chang, Chia Lun Chang, Yun Feng Cheng, Szu Yuan Wu

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Prospective randomized trials have not been used to evaluate the efficacy of adjuvant therapies after intrahepatic cholangiocarcinoma (ICC) resection. Methods: We analyzed data from the Taiwan Cancer Registry database of ICC patients receiving resection. To compare outcomes, patients with ICC were enrolled and categorized into the following adjuvant treatment modality groups: group 1, concurrent chemoradiotherapy (CCRT); group 2, sequential chemotherapy (CT) and radiotherapy (RT); and group 3, CT alone. Results: We enrolled 599 patients with resectable ICC who received surgery without distant metastasis. Of these patients, 174 received adjuvant CCRT (group 1), 146 received adjuvant sequential CT and RT (group 2), and 279 received adjuvant CT alone (group 3). Multivariate Cox regression analysis indicated that pathologic stage and positive margin were significantly poor independent predictors. After adjustment for confounders, adjusted hazard ratios (95% confidence intervals) for overall mortality at advanced pathologic stages III and IV were 0.55 (0.41–0.74) and 0.92 (0.70–1.33) in groups 1 and 2, respectively, compared with group 3. Conclusions: Adjuvant CCRT improved survival in resected ICC with advanced pathologic stages or a positive margin in early pathologic stages compared with adjuvant CT alone or adjuvant sequential CT and RT.

Original languageEnglish
JournalRadiotherapy and Oncology
DOIs
Publication statusAccepted/In press - Jan 1 2018

Fingerprint

Cholangiocarcinoma
Chemoradiotherapy
Adjuvant Chemotherapy
Drug Therapy
Adjuvant Chemoradiotherapy
Adjuvant Radiotherapy
Taiwan
Registries
Radiotherapy
Regression Analysis
Databases
Confidence Intervals
Neoplasm Metastasis
Survival
Mortality
Therapeutics
Neoplasms

Keywords

  • Adjuvant chemotherapy alone
  • Adjuvant sequential chemoradiotherapy
  • Concurrent chemoradiotherapy
  • Intrahepatic cholangiocarcinoma
  • Survival

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Radiology Nuclear Medicine and imaging

Cite this

@article{d37124cd02eb4dba8af7452fe705a64a,
title = "Outcomes of adjuvant treatments for resectable intrahepatic cholangiocarcinoma: Chemotherapy alone, sequential chemoradiotherapy, or concurrent chemoradiotherapy",
abstract = "Background: Prospective randomized trials have not been used to evaluate the efficacy of adjuvant therapies after intrahepatic cholangiocarcinoma (ICC) resection. Methods: We analyzed data from the Taiwan Cancer Registry database of ICC patients receiving resection. To compare outcomes, patients with ICC were enrolled and categorized into the following adjuvant treatment modality groups: group 1, concurrent chemoradiotherapy (CCRT); group 2, sequential chemotherapy (CT) and radiotherapy (RT); and group 3, CT alone. Results: We enrolled 599 patients with resectable ICC who received surgery without distant metastasis. Of these patients, 174 received adjuvant CCRT (group 1), 146 received adjuvant sequential CT and RT (group 2), and 279 received adjuvant CT alone (group 3). Multivariate Cox regression analysis indicated that pathologic stage and positive margin were significantly poor independent predictors. After adjustment for confounders, adjusted hazard ratios (95{\%} confidence intervals) for overall mortality at advanced pathologic stages III and IV were 0.55 (0.41–0.74) and 0.92 (0.70–1.33) in groups 1 and 2, respectively, compared with group 3. Conclusions: Adjuvant CCRT improved survival in resected ICC with advanced pathologic stages or a positive margin in early pathologic stages compared with adjuvant CT alone or adjuvant sequential CT and RT.",
keywords = "Adjuvant chemotherapy alone, Adjuvant sequential chemoradiotherapy, Concurrent chemoradiotherapy, Intrahepatic cholangiocarcinoma, Survival",
author = "Lin, {Yen Kuang} and Hsieh, {Mao Chih} and Wang, {Wei Wei} and Lin, {Yi Chun} and Chang, {Wei Wen} and Chang, {Chia Lun} and Cheng, {Yun Feng} and Wu, {Szu Yuan}",
year = "2018",
month = "1",
day = "1",
doi = "10.1016/j.radonc.2018.05.011",
language = "English",
journal = "Radiotherapy and Oncology",
issn = "0167-8140",
publisher = "Elsevier Ireland Ltd",

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TY - JOUR

T1 - Outcomes of adjuvant treatments for resectable intrahepatic cholangiocarcinoma

T2 - Chemotherapy alone, sequential chemoradiotherapy, or concurrent chemoradiotherapy

AU - Lin, Yen Kuang

AU - Hsieh, Mao Chih

AU - Wang, Wei Wei

AU - Lin, Yi Chun

AU - Chang, Wei Wen

AU - Chang, Chia Lun

AU - Cheng, Yun Feng

AU - Wu, Szu Yuan

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: Prospective randomized trials have not been used to evaluate the efficacy of adjuvant therapies after intrahepatic cholangiocarcinoma (ICC) resection. Methods: We analyzed data from the Taiwan Cancer Registry database of ICC patients receiving resection. To compare outcomes, patients with ICC were enrolled and categorized into the following adjuvant treatment modality groups: group 1, concurrent chemoradiotherapy (CCRT); group 2, sequential chemotherapy (CT) and radiotherapy (RT); and group 3, CT alone. Results: We enrolled 599 patients with resectable ICC who received surgery without distant metastasis. Of these patients, 174 received adjuvant CCRT (group 1), 146 received adjuvant sequential CT and RT (group 2), and 279 received adjuvant CT alone (group 3). Multivariate Cox regression analysis indicated that pathologic stage and positive margin were significantly poor independent predictors. After adjustment for confounders, adjusted hazard ratios (95% confidence intervals) for overall mortality at advanced pathologic stages III and IV were 0.55 (0.41–0.74) and 0.92 (0.70–1.33) in groups 1 and 2, respectively, compared with group 3. Conclusions: Adjuvant CCRT improved survival in resected ICC with advanced pathologic stages or a positive margin in early pathologic stages compared with adjuvant CT alone or adjuvant sequential CT and RT.

AB - Background: Prospective randomized trials have not been used to evaluate the efficacy of adjuvant therapies after intrahepatic cholangiocarcinoma (ICC) resection. Methods: We analyzed data from the Taiwan Cancer Registry database of ICC patients receiving resection. To compare outcomes, patients with ICC were enrolled and categorized into the following adjuvant treatment modality groups: group 1, concurrent chemoradiotherapy (CCRT); group 2, sequential chemotherapy (CT) and radiotherapy (RT); and group 3, CT alone. Results: We enrolled 599 patients with resectable ICC who received surgery without distant metastasis. Of these patients, 174 received adjuvant CCRT (group 1), 146 received adjuvant sequential CT and RT (group 2), and 279 received adjuvant CT alone (group 3). Multivariate Cox regression analysis indicated that pathologic stage and positive margin were significantly poor independent predictors. After adjustment for confounders, adjusted hazard ratios (95% confidence intervals) for overall mortality at advanced pathologic stages III and IV were 0.55 (0.41–0.74) and 0.92 (0.70–1.33) in groups 1 and 2, respectively, compared with group 3. Conclusions: Adjuvant CCRT improved survival in resected ICC with advanced pathologic stages or a positive margin in early pathologic stages compared with adjuvant CT alone or adjuvant sequential CT and RT.

KW - Adjuvant chemotherapy alone

KW - Adjuvant sequential chemoradiotherapy

KW - Concurrent chemoradiotherapy

KW - Intrahepatic cholangiocarcinoma

KW - Survival

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