Postoperative adjuvant chemotherapy for resectable cholangiocarcinoma

Luvira, Vor; Satitkarnmanee, Egapong; Pugkhem, Ake; Kietpeerakool, Chumnan; Lumbiganon, Pisake; Kamsa‐ard, Supot; Pattanittum, Porjai

doi:10.1002/14651858.cd012814.pub2

Cited by 22 publications

(10 citation statements)

References 94 publications

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“…In prior research that enrolled 186 node-positive perihilar cholangiocarcinoma patients, the RFS was longer in the S-1 group than in the gemcitabine-based group (median, 24.4 months vs 14.9 months; P=0.044) among patients who underwent postoperative adjuvant therapy (32). Another author reported that in unresectable biliary tract cancer (243 patients total), S-1based and gemcitabine-based chemotherapy showed similar efficacy in terms of response rate (RR), disease control rate (DCR), PFS and OS (33,34). In our current research, 13 patients underwent chemotherapy containing S-1 also presented improved survival.…”

Section: Discussionsupporting

confidence: 53%

Clinicopathological characteristics and outcome of primary sarcomatoid carcinoma of the gallbladder

Zou

Hu²,

Lv³

et al. 2022

Front. Oncol.

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PurposeOur study aims to examine the clinicopathological features, disease progression, management, and outcomes of gallbladder sarcomatoid carcinoma (GBSC) patients.MethodsBetween January 2000 and December 2020, 50 gallbladder cancer (GBC) patients who received surgical treatment and were pathologically verified as GBSC at our institution were enrolled. The clinical and pathological features and survival of these patients were retrospectively reviewed.ResultsThe median overall survival (OS) of GBSC patients was 14.5 months, and the 1-, 2- and 3-year OS rates were 68.0%, 32.0%, and 10.0%, respectively. The median progression-free survival (PFS) was 10.0 months, and the 1-, 2-, and 3-year PFS rates were 42.0%, 16.0%, and 2.0%, respectively. Patients who received radical resection had obviously better OS (18.0 vs. 7.0 months, P<0.001) and PFS (12.0 vs. 5.0 months, P<0.001) than those who underwent palliative resection. Multivariate analysis revealed that vascular invasion (P=0.033), curative operation (P<0.001) and postoperative chemotherapy (P=0.033) were independent risk factors for PFS. We further identified postoperative chemotherapy (P=0.010) and curative operation (P<0.001) as independent prognostic factors affecting the OS of GBSC patients. After curative surgery, patients who underwent S-1-based chemotherapy showed significantly longer recurrence-free survival (RFS) than those who underwent other chemotherapy regimens (20.0 vs 11.0 months, P=0.028).ConclusionGBSC patients always have aggressive biological behaviors and remarkably poor prognoses. Most GBSC patients are diagnosed in advanced stages, and timely radical operation together with postoperative chemotherapy is important. S-1-based chemotherapy may be a selectively efficient regimen to prolong the survival of GBSC patients.

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Section: Discussionsupporting

confidence: 53%

Clinicopathological characteristics and outcome of primary sarcomatoid carcinoma of the gallbladder

Zou

Hu²,

Lv³

et al. 2022

Front. Oncol.

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“…Adjuvant therapy is often used as an important method of tumor treatment, but the therapeutic effect of adjuvant therapy on ICC is still unestablished [50][51][52]. A study has shown that the prognosis of ICC patients in the narrow-margin group can be similar to that in the wide-margin group after radiotherapy [26].…”

Section: Discussionmentioning

confidence: 99%

The influence of resection margin width in patients with intrahepatic cholangiocarcinoma: a meta-analysis

Dai

et al. 2023

World J Surg Onc

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Background Some studies have pointed out that a wide resection margin can improve the prognosis of intrahepatic cholangiocarcinoma, but some researchers disagree and believe that a wide margin may increase complications. The optimal margin length of intrahepatic cholangiocarcinoma is controversial. Method The literature was searched in PubMed, MedLine, Embase, the Cochrane Library, and Web of Science until December 31, 2021, to evaluate the postoperative outcomes of patients with different margin width after resection. Odds ratios (ORs) with 95% confidence intervals were used to determine the effect size. Result A total of 11 articles were included in this meta-analysis, including 3007 patients. The narrow group had significantly lower 1-, 3-, and 5-year overall survival rates and recurrence-free survival rates than the wide group. Postoperative morbidity and prognostic factors were also evaluated. Conclusion A resection margin width of over 10 mm is recommended in intrahepatic cholangiocarcinoma patients, especially in patients with negative lymph node and early tumor stage. When the resection margin width cannot be greater than 10 mm, we should ensure that the resection margin width is greater than 5 mm.

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“…160 Gathering from all existing literature, one systematic review concluded adjuvant chemotherapy has not been sufficiently proven to improve mortality in resected biliary tract cancers. 164 However, other systematic reviews that collected both retrospective and prospective studies have noted better OS and recurrence-free survival with adjuvant chemotherapy compared to surgery alone, especially notable among those with positive lymph nodes and/or positive margins. 165,166 Current treatment guidelines within American Society of Clinical Oncology (ASCO) suggests a shared-decision approach acknowledging the known research limitations and overall risk-benefit ratio gathered from all of these studies, with special focus on suggested treatment directions noted in both BILCAP and SWOG 0809.…”

Section: Adjuvant Therapymentioning

confidence: 98%

The multidisciplinary management of cholangiocarcinoma

Ohaegbulam

Koethe

Fung

et al. 2022

Cancer

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Cholangiocarcinoma is a lethal malignancy of the biliary epithelium that can arise anywhere along the biliary tract. Surgical resection confers the greatest likelihood of long‐term survivability. However, its insidious onset, difficult diagnostics, and resultant advanced presentation render the majority of patients unresectable, highlighting the importance of early detection with novel biomarkers. Developing liver‐directed therapies and emerging targeted therapeutics may offer improved survivability for patients with unresectable or advanced disease. In this article, the authors review the current multidisciplinary standards of care in resectable and unresectable cholangiocarcinoma, with an emphasis on novel biomarkers for early detection and nonsurgical locoregional therapy options.

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Postoperative adjuvant chemotherapy for resectable cholangiocarcinoma

Cited by 22 publications

References 94 publications

Clinicopathological characteristics and outcome of primary sarcomatoid carcinoma of the gallbladder

Clinicopathological characteristics and outcome of primary sarcomatoid carcinoma of the gallbladder

The influence of resection margin width in patients with intrahepatic cholangiocarcinoma: a meta-analysis

The multidisciplinary management of cholangiocarcinoma

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