Adjuvant therapy is associated with improved survival after curative resection for hilar cholangiocarcinoma: A multi‐institution analysis from the U.S. extrahepatic biliary malignancy consortium

Adjuvant therapy is associated with improved survival after curative resection for hilar... INTRODUCTIONCholangiocarcinoma accounts for 3% of gastrointestinal malignancies worldwide, with 3500 cases diagnosed per year in the United States, the majority of which (60‐80%) arise in the perihilar region. Unresectable disease has a dismal prognosis, with a median survival of less than 1 year. Margin negative R0 resection provides the only chance for long‐term cure. Despite this, resectable disease has a 5‐year survival between 20% and 50%. Adjuvant therapy (AT) has been advocated after resected hilar cholangiocarcinoma (HC) to improve outcomes.The role of AT for resected HC is a source of significant debate. Current National Comprehensive Cancer Network (NCCN) guidelines for AT in resected HC comment that more data are necessary in order to make firm conclusions. In two recent retrospective reviews of AT in biliary tract cancer (BTC), no survival benefit was found. Conversely, within the last 10 years three single center retrospective studies have demonstrated a survival benefit with AT in resected extrahepatic cholangiocarcinoma. In the only published phase III randomized trial of AT that included patients with HC, and in the recently completed phase III trial of gemcitabine plus oxaliplatin in BTC, there was no significant survival benefit noted.Herein, we sought to determine the role of AT http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Surgical Oncology Wiley

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Publisher
Wiley
Copyright
© 2018 Wiley Periodicals, Inc.
ISSN
0022-4790
eISSN
1096-9098
D.O.I.
10.1002/jso.24836
Publisher site
See Article on Publisher Site

Abstract

INTRODUCTIONCholangiocarcinoma accounts for 3% of gastrointestinal malignancies worldwide, with 3500 cases diagnosed per year in the United States, the majority of which (60‐80%) arise in the perihilar region. Unresectable disease has a dismal prognosis, with a median survival of less than 1 year. Margin negative R0 resection provides the only chance for long‐term cure. Despite this, resectable disease has a 5‐year survival between 20% and 50%. Adjuvant therapy (AT) has been advocated after resected hilar cholangiocarcinoma (HC) to improve outcomes.The role of AT for resected HC is a source of significant debate. Current National Comprehensive Cancer Network (NCCN) guidelines for AT in resected HC comment that more data are necessary in order to make firm conclusions. In two recent retrospective reviews of AT in biliary tract cancer (BTC), no survival benefit was found. Conversely, within the last 10 years three single center retrospective studies have demonstrated a survival benefit with AT in resected extrahepatic cholangiocarcinoma. In the only published phase III randomized trial of AT that included patients with HC, and in the recently completed phase III trial of gemcitabine plus oxaliplatin in BTC, there was no significant survival benefit noted.Herein, we sought to determine the role of AT

Journal

Journal of Surgical OncologyWiley

Published: Jan 1, 2018

Keywords: ; ; ; ;

References

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