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Comparing Survival of Perihilar Cholangiocarcinoma After R1 Resection Versus Palliative Chemotherapy for Unresected Localized Disease

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Title: Comparing Survival of Perihilar Cholangiocarcinoma After R1 Resection Versus Palliative Chemotherapy for Unresected Localized Disease
Authors: van Keulen, Anne-Marleen, Buettner, Stefan, Olthof, Pim B., Klümpen, Heinz-Josef, Erdmann, Joris I., Izquierdo-Sanchez, Laura, Banales, Jesus M., Goeppert, Benjamin, Roessler, Stephanie, Zieniewicz, Krzysztof, Lamarca, Angela, Valle, Juan W., La Casta, Adelaida, Hoogwater, Frederik J. H., Donadon, Matteo, Scheiter, Alexander, Marzioni, Marco, Adeva, Jorge, Kiudeliene, Edita, Fernández, Jesús María Urman, Vidili, Gianpaolo, Mocan, Tudor, Fabris, Luca, Krawczyk, Marcin, Folseraas, Trine, Dopazo, Cristina, Detry, Olivier, Voiosu, Theodor, Scripcariu, Viorel, Biancaniello, Francesca, Braconi, Chiara, Macias, Rocio I. R., Groot Koerkamp, Bas
Contributors: Institut Català de la Salut, [van Keulen AM, Buettner S, Olthof PB] Department of Surgery, Erasmus MC Cancer Institute, Rotterdam, The Netherlands. [Klümpen HJ] Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands. [Erdmann JI] Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands. [Izquierdo Sanchez L] Department of Liver and Gastrointestinal Diseases, Biodonostia Health Research Institute, Donostia University Hospital, University of the Basque Country (UPV/EHU), San Sebastian, Spain. National Institute for the Study of Liver and Gastrointestinal Diseases, Instituto de Salud Carlos III' (ISCIII), CIBERehd, Madrid, Spain. [Dopazo C] Servei de Cirurgia Hepatobiliopancreàtica i Trasplantaments, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona
Source: Ann Surg Oncol
Scientia
Scientia. Dipòsit d'Informació Digital del Departament de Salut
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Dipòsit Digital de Documents de la UAB
Universitat Autònoma de Barcelona
Publisher Information: Springer Science and Business Media LLC, 2024.
Publication Year: 2024
Subject Terms: Male, Conductes biliars - Càncer - Tractament, TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::terapéutica::asistencia al paciente::cuidados paliativos, Oncologie, ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Mortality::Survival Rate, liver, Sciences de la santé humaine, chirurgie, ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Therapeutics::Patient Care::Palliative Care, surgery, 03 medical and health sciences, Klatskin Tumor/mortality [MeSH], Female [MeSH], Klatskin Tumor/drug therapy [MeSH], Follow-Up Studies [MeSH], Bile Duct Neoplasms/mortality [MeSH], Aged [MeSH], Humans [MeSH], Klatskin Tumor/pathology [MeSH], Retrospective Studies [MeSH], Bile Duct Neoplasms/pathology [MeSH], Middle Aged [MeSH], Antineoplastic Combined Chemotherapy Protocols/therapeutic use [MeSH], Klatskin Tumor/surgery [MeSH], Survival Rate [MeSH], Palliative Care/methods [MeSH], Male [MeSH], Bile Duct Neoplasms/surgery [MeSH], Prognosis [MeSH], Bile Duct Neoplasms/drug therapy [MeSH], Hepatobiliary Tumors, Hepatectomy/mortality [MeSH], 0302 clinical medicine, Anàlisi de supervivència (Biometria), Antineoplastic Combined Chemotherapy Protocols, cancer, Humans, Hepatectomy, Human health sciences, Chirurgie, TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::intervenciones quirúrgicas::procedimientos quirúrgicos del sistema digestivo::hepatectomía, Aged, Retrospective Studies, Palliative Care, ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Surgical Procedures, Operative::Digestive System Surgical Procedures::Hepatectomy, Gastroentérologie & hépatologie, Middle Aged, foie, Prognosis, 3. Good health, Fetge - Cirurgia, Survival Rate, Oncology, Bile Duct Neoplasms, Tractament pal·liatiu, DISEASES::Neoplasms::Neoplasms by Site::Digestive System Neoplasms::Biliary Tract Neoplasms::Bile Duct Neoplasms, TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::técnicas de investigación::métodos epidemiológicos::recopilación de datos::estadísticas vitales::mortalidad::tasa de supervivencia, cholangiocarcinome, ENFERMEDADES::neoplasias::neoplasias por localización::neoplasias del sistema digestivo::neoplasias del tracto biliar::neoplasias de los conductos biliares, Surgery, Female, cholangiocarcinoma, Gastroenterology & hepatology, Klatskin Tumor, Follow-Up Studies
Description: Background Resection of perihilar cholangiocarcinoma (pCCA) is a complex procedure with a high risk of postoperative mortality and early disease recurrence. The objective of this study was to compare patient characteristics and overall survival (OS) between pCCA patients who underwent an R1 resection and patients with localized pCCA who received palliative systemic chemotherapy. Methods Patients with a diagnosis of pCCA between 1997–2021 were identified from the European Network for the Study of Cholangiocarcinoma (ENS-CCA) registry. pCCA patients who underwent an R1 resection were compared with patients with localized pCCA (i.e., nonmetastatic) who were ineligible for surgical resection and received palliative systemic chemotherapy. The primary outcome was OS. Results Overall, 146 patients in the R1 resection group and 92 patients in the palliative chemotherapy group were included. The palliative chemotherapy group more often underwent biliary drainage (95% vs. 66%, p < 0.001) and had more vascular encasement on imaging (70% vs. 49%, p = 0.012) and CA 19.9 was more frequently >200 IU/L (64 vs. 45%, p = 0.046). Median OS was comparable between both groups (17.1 vs. 16 months, p = 0.06). Overall survival at 5 years after diagnosis was 20.0% with R1 resection and 2.2% with chemotherapy. Type of treatment (i.e., R1 resection or palliative chemotherapy) was not an independent predictor of OS (hazard ratio 0.76, 95% confidence interval 0.55–1.07). Conclusions Palliative systemic chemotherapy should be considered instead of resection in patients with a high risk of both R1 resection and postoperative mortality.
Document Type: Article
Other literature type
File Description: application/pdf
Language: English
ISSN: 1534-4681
1068-9265
DOI: 10.1245/s10434-024-15582-5
Access URL: https://pubmed.ncbi.nlm.nih.gov/38896226
https://hdl.handle.net/11351/11979
https://repository.publisso.de/resource/frl:6517585
Rights: CC BY
Accession Number: edsair.doi.dedup.....aa06031f5015ca1d8dfd5bba9ec213c7
Database: OpenAIRE
Description
Abstract:Background Resection of perihilar cholangiocarcinoma (pCCA) is a complex procedure with a high risk of postoperative mortality and early disease recurrence. The objective of this study was to compare patient characteristics and overall survival (OS) between pCCA patients who underwent an R1 resection and patients with localized pCCA who received palliative systemic chemotherapy. Methods Patients with a diagnosis of pCCA between 1997–2021 were identified from the European Network for the Study of Cholangiocarcinoma (ENS-CCA) registry. pCCA patients who underwent an R1 resection were compared with patients with localized pCCA (i.e., nonmetastatic) who were ineligible for surgical resection and received palliative systemic chemotherapy. The primary outcome was OS. Results Overall, 146 patients in the R1 resection group and 92 patients in the palliative chemotherapy group were included. The palliative chemotherapy group more often underwent biliary drainage (95% vs. 66%, p < 0.001) and had more vascular encasement on imaging (70% vs. 49%, p = 0.012) and CA 19.9 was more frequently >200 IU/L (64 vs. 45%, p = 0.046). Median OS was comparable between both groups (17.1 vs. 16 months, p = 0.06). Overall survival at 5 years after diagnosis was 20.0% with R1 resection and 2.2% with chemotherapy. Type of treatment (i.e., R1 resection or palliative chemotherapy) was not an independent predictor of OS (hazard ratio 0.76, 95% confidence interval 0.55–1.07). Conclusions Palliative systemic chemotherapy should be considered instead of resection in patients with a high risk of both R1 resection and postoperative mortality.
ISSN:15344681
10689265
DOI:10.1245/s10434-024-15582-5