Adjuvant cytotoxic chemotherapy may not be associated with a survival advantage for resected intrahepatic cholangiocarcinoma Journal Article
| Authors: | Sharib, J.; Rhodin, K. E.; Liu, A.; McIntyre, S.; Bartholomew, A.; Masoud, S.; DeLaura, I.; Kemeny, N. E.; Cercek, A.; Harding, J. J.; O’Reilly, E. M.; Abou-Alfa, G. K.; Reidy-Lagunes, D.; Connell, L. C.; El Dika, I.; Balachandran, V. P.; Drebin, J.; Soares, K. C.; Wei, A. C.; Kingham, T. P.; D’Angelica, M. I.; Uronis, H.; Strickler, J.; Hsu, S. D.; Morse, M.; Zani, S.; Allen, P. J.; Jarnagin, W. R.; Lidsky, M. E. |
| Article Title: | Adjuvant cytotoxic chemotherapy may not be associated with a survival advantage for resected intrahepatic cholangiocarcinoma |
| Abstract: | Background: Randomized data suggest improved survival with adjuvant chemotherapy for biliary tract cancers; however, subset analyses of intrahepatic cholangiocarcinoma (IHC) show limited survival benefit. This study evaluated the impact of adjuvant chemotherapy on recurrence patterns and overall survival (OS) in patients with resected IHC. Methods: Patients who underwent curative-intent resection for IHC were identified within a bi-institutional dataset and the National Cancer Database (NCDB). Patients were stratified by receipt of adjuvant chemotherapy. Site of first recurrence was categorized as liver only, regional, distant, or multifocal. Survival outcomes within each dataset were compared using Kaplan–Meier methods. Results: In the bi-institutional dataset, 347 patients underwent resection for IHC, and 149 (43%) patients received adjuvant cytotoxic chemotherapy. Recurrence was observed in 222 (64.0%) patients. OS was similar between groups (adjuvant vs. observation: 42 vs. 49 months; p = 0.13), and did not differ in patients who received capecitabine specifically (p = 0.09) or in a risk-adjusted multivariable analysis. Recurrence-free survival was worse in those who received adjuvant chemotherapy (p = 0.04), although the liver was the most common site of recurrence in both groups (0.63). A similar analysis of 1159 resected IHCs from the NCDB also demonstrated no association between adjuvant chemotherapy and OS (49 vs. 57 months; p = 0.1). Conclusion: Adjuvant chemotherapy may not be associated with improved OS in IHC and did not have an impact on hepatic recurrence in this retrospective analysis. Future investigation to identify more effective adjuvant systemic regimens and/or explore the potential role of adjuvant liver-directed therapies to reduce hepatic recurrence that may improve OS for IHC is warranted. © Society of Surgical Oncology 2025. |
| Keywords: | adult; cancer survival; controlled study; aged; middle aged; cancer surgery; survival rate; retrospective studies; major clinical study; overall survival; mortality; cancer recurrence; postoperative period; cisplatin; cytotoxic agent; fluorouracil; systemic therapy; capecitabine; gemcitabine; cancer patient; chemotherapy, adjuvant; follow up; follow-up studies; antineoplastic agent; lymph node dissection; neoplasm recurrence, local; tumor volume; antineoplastic combined chemotherapy protocols; cohort analysis; pathology; retrospective study; cancer mortality; distant metastasis; age; liver metastasis; tumor recurrence; adjuvant chemotherapy; cancer size; surgery; hepatectomy; intrahepatic cholangiocarcinoma; bile duct carcinoma; bile duct neoplasms; cholangiocarcinoma; drug therapy; oxaliplatin; perineural invasion; recurrence free survival; surgical margin; bile duct tumor; lymph vessel metastasis; humans; prognosis; human; male; female; article; segmentectomy; cancer free survival |
| Journal Title: | Annals of Surgical Oncology |
| Volume: | 32 |
| Issue: | 4 |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Date Published: | 2025-04-01 |
| Start Page: | 2456 |
| End Page: | 2466 |
| Language: | English |
| DOI: | 10.1245/s10434-024-16799-0 |
| PUBMED: | 39827317 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PDF -- Source: Scopus |
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