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Benefit of neoadjuvant concurrent chemoradiotherapy for locally advanced perihilar cholangiocarcinoma

 Jang Han Jung  ;  Hyun Jik Lee  ;  Hee Seung Lee  ;  Jung Hyun Jo  ;  In Rae Cho  ;  Moon Jae Chung  ;  Jeong Youp Park  ;  Seung Woo Park  ;  Si Young Song  ;  Seungmin Bang 
 WORLD JOURNAL OF GASTROENTEROLOGY, Vol.23(18) : 3301-3308, 2017 
Journal Title
Issue Date
Aged ; Biopsy ; Chemoradiotherapy* ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Klatskin Tumor/drug therapy* ; Klatskin Tumor/radiotherapy* ; Male ; Middle Aged ; Multivariate Analysis ; Neoadjuvant Therapy* ; Neoplasm Staging ; Republic of Korea ; Retrospective Studies ; Treatment Outcome
Chemoradiotherapy ; Klatskin tumor ; Locally advanced ; Neoadjuvant therapy ; Survival rate
AIM: To clarify the role of neoadjuvant concurrent chemoradiotherapy (NACCRT) followed by surgical resection for localized or locally advanced perihilar cholangiocarcinoma (CCA). METHODS: We retrospectively reviewed 57 patients who underwent surgical resection with or without NACCRT for perihilar CCA; 12 patients received NACCRT and 45 patients did not received NACCRT. Patients with locally advanced perihilar CCA requiring NACCRT were defined as follows: (1) a mass involving unilateral branches of the portal vein or hepatic artery with insufficient volume of the anticipated remnant lobe; or (2) an infiltrating mass in the main portal vein that was too long for reconstruction, identified at preoperative staging. RESULTS: The median disease-free survival (DFS) durations of the neoadjuvant and non-neoadjuvant CCRT groups were 26.0 and 15.1 mo, respectively (P = 0.91). The median overall survival (OS) durations of the neoadjuvant and non-neoadjuvant CCRT groups were 32.9 and 27.1 mo, respectively (P = 0.26). The NACCRT group showed a downstaging tendency compared to the non-NACCRT group as compared with the tumor stage confirmed by histological examination after surgery and the tumor stage confirmed by imaging test at the time of diagnosis (P = 0.01). CONCLUSION: NACCRT does not prolong DFS and OS in localized or locally advanced perihilar CCA. However, NACCRT may allow tumor downstaging and improve tumor resectability.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Park, Seung Woo(박승우) ORCID logo https://orcid.org/0000-0001-8230-964X
Park, Jeong Youp(박정엽) ORCID logo https://orcid.org/0000-0003-0110-8606
Bang, Seungmin(방승민) ORCID logo https://orcid.org/0000-0001-5209-8351
Song, Si Young(송시영) ORCID logo https://orcid.org/0000-0002-1417-4314
Lee, Hyun Jik(이현직)
Lee, Hee Seung(이희승) ORCID logo https://orcid.org/0000-0002-2825-3160
Chung, Moon Jae(정문재) ORCID logo https://orcid.org/0000-0002-5920-8549
Jung, Jang Han(정장한)
Cho, In Rae(조인래)
Jo, Jung Hyun(조중현) ORCID logo https://orcid.org/0000-0002-2641-8873
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