Adjuvant chemoradiotherapy for positive hepatic ductal margin on cholangiocarcinoma. Issue 4 (15th May 2020)

• Record Type: Journal Article
• Authors: Sugiura, Teiichi; Uesaka, Katsuhiko; Okamura, Yukiyasu; Ito, Takaaki; Yamamoto, Yusuke; Ashida, Ryo; Ohgi, Katsuhisa; Asakura, Hirofumi; Todaka, Akiko; Fukutomi, Akira
• Is Part Of: Annals of gastroenterological surgery. Volume 4:Issue 4(2020)
• Page Start: 455
• Page End: 463
• Publication Date: 2020-05-15
• Subjects: adjuvant chemoradiotherapy -- cholangiocarcinoma -- positive ductal margin -- stump recurrence -- survival; Digestive organs -- Surgery -- Periodicals; 617.43
• DOI: 10.1002/ags3.12345
• Languages: English
• ISSNs: 2475-0328

Abstract

Abstract: Aim: This study evaluated the effects of postoperative adjuvant chemoradiotherapy (A‐CRT) for positive hepatic ductal margin (HM+) in extrahepatic cholangiocarcinoma (EHCC). Methods: Patients with EHCC who underwent surgical resection between 2002 and 2014 were included in this retrospective study. For patients with HM+, A‐CRT was conducted. The clinical effect of A‐CRT for HM+ on the survival and recurrence and prognostic factors of EHCC was reviewed. Results: Among 340 patients, the hepatic ductal margin was negative in 296 and positive in 44. Of the 44 patients with HM+, 22 received postoperative A‐CRT, and 22 did not. Hepatic stump recurrence occurred in 19 patients. The incidence was significantly higher in patients with HM+ (20%, 9/44) than in those with negative hepatic ductal margin (HM−) (3%, 10/296) ( P < .001). Among the patients with HM+, the incidence was almost identical between the patients with and without A‐CRT: 23% (5/22) in HM+/CRT− and 18% (4/22) in HM+/CRT+ patients ( P = .999). The median survival time was 49 months in HM−, 43 months in HM+/CRT−, and 49 months in HM+/CRT+ patients. The differences were not significant among the groups. A multivariate analysis revealed CA 19‐9 ≥ 300 U/mL, combined vascular resection, histologic grade G2/G3, and lymph node metastasis to be significant prognostic factors. However, the performance of postoperative A‐CRT did not contribute to prolonging survival. Conclusion: A‐CRT for HM+ in patients with EHCC did not affect the survival or stump recurrence. Abstract : Adjuvant chemoradiotherapy was delivered for positive hepatic ductal margin in cholangiocarcinoma. However, this treatment did not affect the survival or stump recurrence.