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

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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.

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Author notes

  1. J. Lee, S. H. Kang, O. K. Noh, and S.-W. Kim have equally contributed to the article.

Authors and Affiliations

  1. Department of Surgery, Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea

    J. Lee

  2. Department of Radiation Oncology, Haeundae Paik Hospital, Inje University School of Medicine, 875 Haeundae-ro, Haeundae-gu, Busan, 48108, Republic of Korea

    S. H. Kang

  3. Department of Radiation Oncology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, Gyeonggi-do, 16499, Republic of Korea

    O. K. Noh, M. Chun, Y.-T. Oh & S.-W. Kim

  4. Department of Biomedical Informatics, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, Gyeonggi-do, 16499, Republic of Korea

    O. K. Noh

  5. Department of Surgery, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, Gyeong-gi do, 16499, Republic of Korea

    B.-W. Kim

  6. Department of Radiation Oncology, Konyang University College of Medicine, 158 Gwanjeodong-ro, Daejeon, 35365, Republic of Korea

    S.-W. Kim

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Lee, J., Kang, S.H., Noh, O.K. et al. Adjuvant concurrent chemoradiation therapy in patients with microscopic residual tumor after curative resection for extrahepatic cholangiocarcinoma. Clin Transl Oncol 20, 1011–1017 (2018). https://doi.org/10.1007/s12094-017-1815-y

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  • DOI: https://doi.org/10.1007/s12094-017-1815-y

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