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Impact of Adjuvant Chemotherapy on Survival in Patients with Intrahepatic Cholangiocarcinoma: a Multi-Institutional Analysis

2017Journal article Open access
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dc.contributor.authorReames, BN
dc.contributor.authorBagante, F
dc.contributor.authorEjaz, A
dc.contributor.authorSpolverato, G
dc.contributor.authorRuzzenente, A
dc.contributor.authorWeiss, M
dc.contributor.authorAlexandrescu, S
dc.contributor.authorPinto Marques, H
dc.contributor.authorAldrighetti, L
dc.contributor.authorMaithel, SK
dc.contributor.authorPulitano, C
dc.contributor.authorBauer, TW
dc.contributor.authorShen, F
dc.contributor.authorPoultsides, GA
dc.contributor.authorSoubrane, O
dc.contributor.authorMartel, G
dc.contributor.authorKoerkamp, BG
dc.contributor.authorGuglielmi, A
dc.contributor.authorItaru, E
dc.contributor.authorPawlik, TM
dc.date.accessioned2019-03-21T10:23:05Z
dc.date.available2019-03-21T10:23:05Z
dc.date.issued2017
dc.description.abstractBACKGROUND: The benefit of adjuvant chemotherapy for resected intrahepatic cholangiocarcinoma (ICC) is unclear. The aim of the current study was to investigate the impact of adjuvant chemotherapy on survival among patients undergoing resection of ICC using a multi-institutional database. METHODS: 1154 ICC patients undergoing curative-intent hepatectomy between 1990 and 2015 were identified from 14 institutions. Cox proportional hazard modeling was used to determine the impact of adjuvant chemotherapy on overall survival (OS). RESULTS: Following resection, 347 (30%) patients received adjuvant chemotherapy, most commonly a gemcitabine-based regimen (n = 184, 52%). Patients with T2/T3/T4 disease were more likely to receive adjuvant therapy compared with patients with T1a/T1b disease (OR 2.5, 95%CI 1.89-3.23; P < 0.001). Among patients who did and did not receive adjuvant therapy, patients with T2/T3/T4 tumors had a 5-year OS of 37% (95%CI 28.9-44.4) versus 30% (95%CI 23.8-35.6), respectively (p = 0.006). Similarly patients with N1 disease who received adjuvant chemotherapy tended to have improved 5-year OS (18.3%, 95%CI 9.0-30.1 vs. no adjuvant therapy 12%, 95%CI 3.9-24.4; P = 0.050). CONCLUSIONS: While adjuvant chemotherapy did not influence the prognosis of all ICC patients following surgical resection, it was associated with a potential survival benefit in subgroups of patients at increased risk for recurrence, such as those with advanced tumors.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationHPB (Oxford). 2017 Oct;19(10):901-909.pt_PT
dc.identifier.doi10.1016/j.hpb.2017.06.008pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/3206
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.subjectAgedpt_PT
dc.subjectAntineoplastic Combined Chemotherapy Protocolspt_PT
dc.subjectAsiapt_PT
dc.subjectAustraliapt_PT
dc.subjectBile Duct Neoplasmspt_PT
dc.subjectChemotherapy, Adjuvantpt_PT
dc.subjectChi-Square Distributionpt_PT
dc.subjectCholangiocarcinomapt_PT
dc.subjectDatabases, Factualpt_PT
dc.subjectDeoxycytidinept_PT
dc.subjectEuropept_PT
dc.subjectHumanspt_PT
dc.subjectKaplan-Meier Estimatept_PT
dc.subjectLogistic Modelspt_PT
dc.subjectMiddle Agedpt_PT
dc.subjectMultivariate Analysispt_PT
dc.subjectNeoplasm Stagingpt_PT
dc.subjectNorth Americapt_PT
dc.subjectOdds Ratiopt_PT
dc.subjectProportional Hazards Modelspt_PT
dc.subjectRetrospective Studiespt_PT
dc.subjectRisk Factorspt_PT
dc.subjectTime Factorspt_PT
dc.subjectTreatment Outcomept_PT
dc.subjectHepatectomypt_PT
dc.subjectHCC CIRpt_PT
dc.titleImpact of Adjuvant Chemotherapy on Survival in Patients with Intrahepatic Cholangiocarcinoma: a Multi-Institutional Analysispt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage909pt_PT
oaire.citation.issue10pt_PT
oaire.citation.startPage901pt_PT
oaire.citation.titleHPBpt_PT
oaire.citation.volume19pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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