Impact of adjuvant chemotherapy on survival in patients with intrahepatic cholangiocarcinoma: a multi-institutional analysis
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. 1154 ICC patients under...
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| Veröffentlicht in: | HPB (Oxford, England) England), 2017-10, Vol.19 (10), p.901-909 |
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| creator | Reames, Bradley N. Bagante, Fabio Ejaz, Aslam Spolverato, Gaya Ruzzenente, Andrea Weiss, Matthew Alexandrescu, Sorin Marques, Hugo P. Aldrighetti, Luca Maithel, Shishir K. Pulitano, Carlo Bauer, Todd W. Shen, Feng Poultsides, George A. Soubrane, Oliver Martel, Guillaume Koerkamp, Bas G. Guglielmi, Alfredo Itaru, Endo Pawlik, Timothy M. |
| description | 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.
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).
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 |
| doi_str_mv | 10.1016/j.hpb.2017.06.008 |
| format | Article |
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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).
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).
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.</description><identifier>ISSN: 1365-182X</identifier><identifier>EISSN: 1477-2574</identifier><identifier>DOI: 10.1016/j.hpb.2017.06.008</identifier><identifier>PMID: 28728891</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Aged ; Antineoplastic Combined Chemotherapy Protocols - adverse effects ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Asia ; Australia ; Bile Duct Neoplasms - mortality ; Bile Duct Neoplasms - pathology ; Bile Duct Neoplasms - therapy ; Chemotherapy, Adjuvant ; Chi-Square Distribution ; Cholangiocarcinoma - mortality ; Cholangiocarcinoma - pathology ; Cholangiocarcinoma - therapy ; Databases, Factual ; Deoxycytidine - administration & dosage ; Deoxycytidine - analogs & derivatives ; Europe ; Hepatectomy - adverse effects ; Hepatectomy - mortality ; Humans ; Kaplan-Meier Estimate ; Logistic Models ; Middle Aged ; Multivariate Analysis ; Neoplasm Staging ; North America ; Odds Ratio ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors ; Time Factors ; Treatment Outcome</subject><ispartof>HPB (Oxford, England), 2017-10, Vol.19 (10), p.901-909</ispartof><rights>2017 International Hepato-Pancreato-Biliary Association Inc.</rights><rights>Copyright © 2017 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c424t-61e757ec1b4e8559ae2c8e3412e0cdea78992ff709be7becdd0a7606d408869c3</citedby><cites>FETCH-LOGICAL-c424t-61e757ec1b4e8559ae2c8e3412e0cdea78992ff709be7becdd0a7606d408869c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28728891$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Reames, Bradley N.</creatorcontrib><creatorcontrib>Bagante, Fabio</creatorcontrib><creatorcontrib>Ejaz, Aslam</creatorcontrib><creatorcontrib>Spolverato, Gaya</creatorcontrib><creatorcontrib>Ruzzenente, Andrea</creatorcontrib><creatorcontrib>Weiss, Matthew</creatorcontrib><creatorcontrib>Alexandrescu, Sorin</creatorcontrib><creatorcontrib>Marques, Hugo P.</creatorcontrib><creatorcontrib>Aldrighetti, Luca</creatorcontrib><creatorcontrib>Maithel, Shishir K.</creatorcontrib><creatorcontrib>Pulitano, Carlo</creatorcontrib><creatorcontrib>Bauer, Todd W.</creatorcontrib><creatorcontrib>Shen, Feng</creatorcontrib><creatorcontrib>Poultsides, George A.</creatorcontrib><creatorcontrib>Soubrane, Oliver</creatorcontrib><creatorcontrib>Martel, Guillaume</creatorcontrib><creatorcontrib>Koerkamp, Bas G.</creatorcontrib><creatorcontrib>Guglielmi, Alfredo</creatorcontrib><creatorcontrib>Itaru, Endo</creatorcontrib><creatorcontrib>Pawlik, Timothy M.</creatorcontrib><title>Impact of adjuvant chemotherapy on survival in patients with intrahepatic cholangiocarcinoma: a multi-institutional analysis</title><title>HPB (Oxford, England)</title><addtitle>HPB (Oxford)</addtitle><description>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.
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).
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).
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.</description><subject>Aged</subject><subject>Antineoplastic Combined Chemotherapy Protocols - adverse effects</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Asia</subject><subject>Australia</subject><subject>Bile Duct Neoplasms - mortality</subject><subject>Bile Duct Neoplasms - pathology</subject><subject>Bile Duct Neoplasms - therapy</subject><subject>Chemotherapy, Adjuvant</subject><subject>Chi-Square Distribution</subject><subject>Cholangiocarcinoma - mortality</subject><subject>Cholangiocarcinoma - pathology</subject><subject>Cholangiocarcinoma - therapy</subject><subject>Databases, Factual</subject><subject>Deoxycytidine - administration & dosage</subject><subject>Deoxycytidine - analogs & derivatives</subject><subject>Europe</subject><subject>Hepatectomy - adverse effects</subject><subject>Hepatectomy - mortality</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Logistic Models</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Neoplasm Staging</subject><subject>North America</subject><subject>Odds Ratio</subject><subject>Proportional Hazards Models</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><issn>1365-182X</issn><issn>1477-2574</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE9r3DAQxUVoyCZpPkAuQcde7Epa25KbUwn5B4FeUuhNjOVxrMW2XEnestAPXy276TGXmWF47zHzI-Sas5wzXn3d5P3c5IJxmbMqZ0ydkHNeSJmJUhaf0ryuyowr8WtFLkLYMCaSrT4jK6GkUKrm5-Tv8ziDidR1FNrNsoUpUtPj6GKPHuYddRMNi9_aLQzUTnSGaHGKgf6xsU-L6KHH_dIkmxtgerPOgDd2ciN8o0DHZYg2s1OINi7RuinlQCq7YMNnctrBEPDq2C_Jz4f717un7OXH4_Pd95fMFKKIWcVRlhINbwpUZVkDCqNwXXCBzLQIUtW16DrJ6gZlg6ZtGciKVW3BlKpqs74kXw65s3e_FwxRjzYYHNK56JageS1Eycp1USYpP0iNdyF47PTs7Qh-pznTe-h6oxN0vYeuWaUT9OS5OcYvzYjtf8c75SS4PQgwPbm16HUwiaLB1no0UbfOfhD_D3tSlhw</recordid><startdate>20171001</startdate><enddate>20171001</enddate><creator>Reames, Bradley N.</creator><creator>Bagante, Fabio</creator><creator>Ejaz, Aslam</creator><creator>Spolverato, Gaya</creator><creator>Ruzzenente, Andrea</creator><creator>Weiss, Matthew</creator><creator>Alexandrescu, Sorin</creator><creator>Marques, Hugo P.</creator><creator>Aldrighetti, Luca</creator><creator>Maithel, Shishir K.</creator><creator>Pulitano, Carlo</creator><creator>Bauer, Todd W.</creator><creator>Shen, Feng</creator><creator>Poultsides, George A.</creator><creator>Soubrane, Oliver</creator><creator>Martel, Guillaume</creator><creator>Koerkamp, Bas G.</creator><creator>Guglielmi, Alfredo</creator><creator>Itaru, Endo</creator><creator>Pawlik, Timothy M.</creator><general>Elsevier Ltd</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20171001</creationdate><title>Impact of adjuvant chemotherapy on survival in patients with intrahepatic cholangiocarcinoma: a multi-institutional analysis</title><author>Reames, Bradley N. ; Bagante, Fabio ; Ejaz, Aslam ; Spolverato, Gaya ; Ruzzenente, Andrea ; Weiss, Matthew ; Alexandrescu, Sorin ; Marques, Hugo P. ; Aldrighetti, Luca ; Maithel, Shishir K. ; Pulitano, Carlo ; Bauer, Todd W. ; Shen, Feng ; Poultsides, George A. ; Soubrane, Oliver ; Martel, Guillaume ; Koerkamp, Bas G. ; Guglielmi, Alfredo ; Itaru, Endo ; Pawlik, Timothy M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c424t-61e757ec1b4e8559ae2c8e3412e0cdea78992ff709be7becdd0a7606d408869c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Aged</topic><topic>Antineoplastic Combined Chemotherapy Protocols - adverse effects</topic><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>Asia</topic><topic>Australia</topic><topic>Bile Duct Neoplasms - mortality</topic><topic>Bile Duct Neoplasms - pathology</topic><topic>Bile Duct Neoplasms - therapy</topic><topic>Chemotherapy, Adjuvant</topic><topic>Chi-Square Distribution</topic><topic>Cholangiocarcinoma - mortality</topic><topic>Cholangiocarcinoma - pathology</topic><topic>Cholangiocarcinoma - therapy</topic><topic>Databases, Factual</topic><topic>Deoxycytidine - administration & dosage</topic><topic>Deoxycytidine - analogs & derivatives</topic><topic>Europe</topic><topic>Hepatectomy - adverse effects</topic><topic>Hepatectomy - mortality</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Logistic Models</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Neoplasm Staging</topic><topic>North America</topic><topic>Odds Ratio</topic><topic>Proportional Hazards Models</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Reames, Bradley N.</creatorcontrib><creatorcontrib>Bagante, Fabio</creatorcontrib><creatorcontrib>Ejaz, Aslam</creatorcontrib><creatorcontrib>Spolverato, Gaya</creatorcontrib><creatorcontrib>Ruzzenente, Andrea</creatorcontrib><creatorcontrib>Weiss, Matthew</creatorcontrib><creatorcontrib>Alexandrescu, Sorin</creatorcontrib><creatorcontrib>Marques, Hugo P.</creatorcontrib><creatorcontrib>Aldrighetti, Luca</creatorcontrib><creatorcontrib>Maithel, Shishir K.</creatorcontrib><creatorcontrib>Pulitano, Carlo</creatorcontrib><creatorcontrib>Bauer, Todd W.</creatorcontrib><creatorcontrib>Shen, Feng</creatorcontrib><creatorcontrib>Poultsides, George A.</creatorcontrib><creatorcontrib>Soubrane, Oliver</creatorcontrib><creatorcontrib>Martel, Guillaume</creatorcontrib><creatorcontrib>Koerkamp, Bas G.</creatorcontrib><creatorcontrib>Guglielmi, Alfredo</creatorcontrib><creatorcontrib>Itaru, Endo</creatorcontrib><creatorcontrib>Pawlik, Timothy M.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>HPB (Oxford, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Reames, Bradley N.</au><au>Bagante, Fabio</au><au>Ejaz, Aslam</au><au>Spolverato, Gaya</au><au>Ruzzenente, Andrea</au><au>Weiss, Matthew</au><au>Alexandrescu, Sorin</au><au>Marques, Hugo P.</au><au>Aldrighetti, Luca</au><au>Maithel, Shishir K.</au><au>Pulitano, Carlo</au><au>Bauer, Todd W.</au><au>Shen, Feng</au><au>Poultsides, George A.</au><au>Soubrane, Oliver</au><au>Martel, Guillaume</au><au>Koerkamp, Bas G.</au><au>Guglielmi, Alfredo</au><au>Itaru, Endo</au><au>Pawlik, Timothy M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of adjuvant chemotherapy on survival in patients with intrahepatic cholangiocarcinoma: a multi-institutional analysis</atitle><jtitle>HPB (Oxford, England)</jtitle><addtitle>HPB (Oxford)</addtitle><date>2017-10-01</date><risdate>2017</risdate><volume>19</volume><issue>10</issue><spage>901</spage><epage>909</epage><pages>901-909</pages><issn>1365-182X</issn><eissn>1477-2574</eissn><abstract>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.
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).
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).
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.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>28728891</pmid><doi>10.1016/j.hpb.2017.06.008</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Antineoplastic Combined Chemotherapy Protocols - adverse effects Antineoplastic Combined Chemotherapy Protocols - therapeutic use Asia Australia Bile Duct Neoplasms - mortality Bile Duct Neoplasms - pathology Bile Duct Neoplasms - therapy Chemotherapy, Adjuvant Chi-Square Distribution Cholangiocarcinoma - mortality Cholangiocarcinoma - pathology Cholangiocarcinoma - therapy Databases, Factual Deoxycytidine - administration & dosage Deoxycytidine - analogs & derivatives Europe Hepatectomy - adverse effects Hepatectomy - mortality Humans Kaplan-Meier Estimate Logistic Models Middle Aged Multivariate Analysis Neoplasm Staging North America Odds Ratio Proportional Hazards Models Retrospective Studies Risk Factors Time Factors Treatment Outcome |
| title | Impact of adjuvant chemotherapy on survival in patients with intrahepatic cholangiocarcinoma: a multi-institutional analysis |
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