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Adjuvant radiotherapy and chemotherapy offer a recurrence and survival benefit in patients with resected perihilar cholangiocarcinoma

  • Original Article – Clinical Oncology
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Abstract

Background and objectives

The objective of this study was to investigate the benefits of adjuvant treatment for patients with resected perihilar cholangiocarcinoma (PHC).

Methods

Between 2001 and 2017, 196 patients with PHC adenocarcinoma underwent curative resection. The patients were divided into four groups according to adjuvant treatment type: surgery alone (S; N = 90), surgery with chemotherapy (S+CTx; N = 67), surgery with radiotherapy (S+RTx; N = 18), and surgery with chemoradiotherapy (S+ CRTx; N = 21).

Results

The median follow-up duration of the surviving patients was 58 months. The 5-year rate of overall survival (OS) was 32%. In multivariate analysis, receiving S+CTx and S+CRTx were significant prognostic factors for OS. In subgroup analyses of the R1 resection patients, the S+CRTx group showed better OS than the S group (p < 0.05). In subgroup analyses of the stage III–IVA patients with a negative resection margin, the S+CTx and S+CRTx groups showed superior OS than the S group (p < 0.05).

Conclusions

Our data suggest that adjuvant chemoradiotherapy might be considered for PHC patients with R1 resection. Adjuvant chemotherapy or chemoradiotherapy is suggested for stage III–IVA patients with R0 resection. The results of this study require validation through further prospective studies.

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Acknowledgments

This work has been presented in the third Asia-Pacific Cholangiocarcinoma Conference, March 15–16, 2019, Taipei, Taiwan. The abstract of this study was accepted for poster presentation at the Annual Meeting of the American Society for Radiation Oncology, Chicago, IL (September, 2019). We would like to thank Editage (www.editage.co.kr) for English language editing.

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Author notes

  1. Jung Ho Im

    Present address: Department of Radiation Oncology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea

Authors and Affiliations

  1. Department of Radiation Oncology, Severance Hospital, Yonsei Cancer Center, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea

    Jung Ho Im & Jinsil Seong

  2. Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea

    Gi Hong Choi, Woo Jung Lee & Dai Hoon Han

  3. Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea

    Seung Woo Park & Seungmin Bang

  4. Division of Medical Oncology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea

    Hye Jin Choi

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Correspondence to Jinsil Seong.

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Im, J.H., Choi, G.H., Lee, W.J. et al. Adjuvant radiotherapy and chemotherapy offer a recurrence and survival benefit in patients with resected perihilar cholangiocarcinoma. J Cancer Res Clin Oncol 147, 2435–2445 (2021). https://doi.org/10.1007/s00432-021-03524-7

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  • DOI: https://doi.org/10.1007/s00432-021-03524-7

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