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World Journal of Surgery

, Volume 42, Issue 9, pp 2910–2918 | Cite as

Chemoradiotherapy for Initially Unresectable Locally Advanced Cholangiocarcinoma

  • Tatsuaki Sumiyoshi
  • Yasuo Shima
  • Takehiro Okabayashi
  • Yuji Negoro
  • Yasuhiro Shimada
  • Jun Iwata
  • Manabu Matsumoto
  • Yasuhiro Hata
  • Yoshihiro Noda
  • Kenta Sui
  • Taijiro Sueda
Original Scientific Report

Abstract

Objective

Surgical resection is the only available treatment for achieving long-term survival in cholangiocarcinoma. The purpose of this study is to elucidate the utility of chemoradiotherapy for initially unresectable locally advanced cholangiocarcinoma.

Methods

Unresectable locally advanced cholangiocarcinoma was defined as those in which radical surgery could not be achieved even with aggressive surgical procedure. Fifteen candidates (7 intrahepatic cholangiocarcinomas and 8 hilar cholangiocarcinomas) underwent chemoradiotherapy. Fourteen of the 15 patients received oral S-1 chemotherapy. Radiotherapy was administered with 50 Gy for each patient. After chemoradiotherapy, the resectability of each cholangiocarcinoma was reexamined.

Results

Of the 15 patients with initially unresectable locally advanced cholangiocarcinoma, 11 (73.3%) were judged to have resectable cholangiocarcinoma after chemoradiotherapy, and received radical hepatectomy (R0 resection in 9 patients). Among the 11 patients who underwent surgical resection, 4 had recurrence-free survival and the median survival time (MST) was 37 months. The overall 1-, 2-, and 5-year survival rates were 80.8, 70.7 and 23.6%, respectively. Among the 4 patients who were unable to receive surgery, 3 died of the primary disease and the MST was 10 months. The overall 1- and 2-year survival rates were 37.5 and 0%, respectively. Patients who received radical surgery had significantly longer survival time than those who were unable to receive surgery (p = 0.027).

Conclusions

Chemoradiotherapy allowed patients with initially unresectable locally advanced cholangiocarcinomas to be reclassified as surgical candidates in a substantial proportion. Chemoradiotherapy might be one of the treatment options for similarly advanced cholangiocarcinomas.

Notes

Compliance with ethical standards

Conflict of interest

Tatsuaki Sumiyoshi and co-authors have no conflict of interest to declare.

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Copyright information

© Société Internationale de Chirurgie 2018

Authors and Affiliations

  • Tatsuaki Sumiyoshi
    • 1
  • Yasuo Shima
    • 1
  • Takehiro Okabayashi
    • 1
  • Yuji Negoro
    • 2
  • Yasuhiro Shimada
    • 2
  • Jun Iwata
    • 3
  • Manabu Matsumoto
    • 3
  • Yasuhiro Hata
    • 4
  • Yoshihiro Noda
    • 4
  • Kenta Sui
    • 1
  • Taijiro Sueda
    • 5
  1. 1.Departments of Gastroenterological SurgeryKochi Health Sciences CenterKochiJapan
  2. 2.Department of Medical OncologyKochi Health Sciences CenterKochiJapan
  3. 3.Departments of Diagnostic PathologyKochi Health Sciences CenterKochiJapan
  4. 4.Departments of RadiologyKochi Health Sciences CenterKochiJapan
  5. 5.Department of Surgery, Applied Life Sciences Institute of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan

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