Adjuvant chemotherapy in resectable cholangiocarcinoma patients

作者：Wirasorn Kosin^*; Ngamprasertchai Thundon; Khuntikeo Narong; Pakkhem Ake; Ungarereevittaya Piti; Chindaprasirt Jarin; Sookprasert Aumkhae

来源：Journal of Gastroenterology and Hepatology, 2013, 28(12): 1885-1891.

DOI：10.1111/jgh.12321

• cholangiocarcinoma &lt
• hepatology
• epidemiology &lt
• hepatology
• liver surgery &lt
• hepatology

Background and AimCholangiocarcinoma patients usually have poor treatment outcome and a high mortality rate. The role of adjuvant chemotherapy (AC) is controversial. Our study aimed to evaluate benefits of AC in resectable cholangiocarcinoma patients.
MethodsA retrospective study included 263 patients who underwent curative resection in Srinakarind University Hospital. These patients had pathological reports showing a clear margin (R0) or microscopic margin (R1) of lesion-free tissue.
ResultsThere were 138 patients who received AC. This group had a significantly lower mean age than patients not receiving adjuvant chemotherapy (NAC) group (57.78.5 vs 60.4 +/- 9.0 years, P=0.01). The level of serum albumin above 3g/dL was more common in AC group than the NAC one (87.7% vs 79.2%, P=0.04). Patients who received AC had significantly longer overall median survival time (21.6 vs 13.4 months, P=0.01). Patients with a combination of gemcitabine and capecitabine regimen had the longest survival time (median overall survival time of gemcitabine and capecitabine 31.5, 5-fluorouracil and mitomycin 17.3, 5-fluorouracil alone 22.2, capecitabine alone 21.6, and gemcitabine alone 7.9 months, P=0.02). Benefits of AC were likely to be found in patients who had high-risk features, that is, high level of carbohydrate antigen 19-9, advanced stage, T4 stage, lymph node involvement, and R1 margin.
ConclusionsAC significantly prolongs survival time in resectable cholangiocarcinoma patients, particularly in the high risk group.

• 出版日期2013-12