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Clinical and Translational Oncology

, Volume 20, Issue 8, pp 1011–1017 | Cite as

Adjuvant concurrent chemoradiation therapy in patients with microscopic residual tumor after curative resection for extrahepatic cholangiocarcinoma

  • J. Lee
  • S. H. Kang
  • O. K. Noh
  • M. Chun
  • Y.-T. Oh
  • B.-W. Kim
  • S.-W. Kim
Research Article

Abstract

Purpose

We investigated the role of adjuvant concurrent chemoradiation therapy (CCRT) in patients with a microscopically positive resection margin (R1) after curative resection for extrahepatic cholangiocarcinoma (EHCC).

Methods/patients

A total of 84 patients treated with curative resection for EHCC were included. Fifty-two patients with negative resection margins did not receive any adjuvant treatments (R0 + S group). The remaining 32 patients with microscopically positive resection margins received either adjuvant CCRT (R1 + CCRT group, n = 19) or adjuvant radiation therapy (RT) alone (R1 + RT group, n = 13).

Results

During the median follow-up period of 26 months, the 2-year locoregional recurrence-free survival (LRRFS), disease-free survival (DFS), and overall survival rates (OS) were: 81.8, 62.6, and 61.5% for R0 + S group; 71.8, 57.8, and 57.9% for R1 + CCRT group; and 16.8, 9.6, and 15.4% for R1 + RT group, respectively. Multivariate analysis revealed that the R1 + CCRT group did not show any significant difference in survival rates compared with the R0 + S group. The R1 + RT group had lower LRRFS [hazard ratio (HR) 3.008; p = 0.044], DFS (HR 2.364; p = 0.022), and OS (HR 2.417; p = 0.011) when compared with the R0 + S and R1 + CCRT group.

Conclusions

A lack of significant survival difference between R0 + S group and R1 + CCRT group suggests that adjuvant CCRT ameliorates the negative effect of microscopic positive resection margin. In contrast, adjuvant RT alone is appeared to be inadequate for controlling microscopically residual tumor.

Keywords

Extrahepatic cholangiocarcinoma Concurrent chemoradiation therapy Positive surgical margin Survival 

Notes

Compliance with ethical standards

Conflict of interest

The authors declared that they have no conflicts of interest.

Informed consent

For this type of study, formal consent is not required.

Research involving human participants and/or animals

This article does not contain any studies with human participants and/or animals performed by any of authors.

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Copyright information

© Federación de Sociedades Españolas de Oncología (FESEO) 2017

Authors and Affiliations

  1. 1.Department of Surgery, Anam HospitalKorea University College of MedicineSeoulRepublic of Korea
  2. 2.Department of Radiation Oncology, Haeundae Paik HospitalInje University School of MedicineBusanRepublic of Korea
  3. 3.Department of Radiation OncologyAjou University School of MedicineSuwonRepublic of Korea
  4. 4.Department of Biomedical InformaticsAjou University School of MedicineSuwonRepublic of Korea
  5. 5.Department of SurgeryAjou University School of MedicineSuwonRepublic of Korea
  6. 6.Department of Radiation OncologyKonyang University College of MedicineDaejeonRepublic of Korea

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