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Adjuvant therapy is associated with improved survival after curative resection for hilar cholangiocarcinoma: A multi‐institution analysis from the U.S. extrahepatic biliary malignancy consortium
Author(s) -
Krasnick Bradley A.,
Jin Linda X.,
Davidson Jesse T.,
Sanford Dominic E.,
Ethun Cecilia G.,
Pawlik Timothy M.,
Poultsides George A.,
Tran Thuy,
Idrees Kamran,
Hawkins William G.,
Chapman William C.,
Doyle Maria B.M.,
Weber Sharon M.,
Strasberg Steven M.,
Salem Ahmed,
Martin Robert C.G.,
Isom Chelsea A.,
Scoggins Charles,
Schmidt Carl R.,
Shen Perry,
Beal Eliza,
Hatzaras Ioannis,
Shenoy Rivfka,
Maithel Shishir K.,
Fields Ryan C.
Publication year - 2018
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.24836
Subject(s) - medicine , malignancy , adjuvant therapy , general surgery , adjuvant , resection , gastroenterology , oncology , surgery , cancer
Background Curative‐intent treatment for localized hilar cholangiocarcinoma (HC) requires surgical resection. However, the effect of adjuvant therapy (AT) on survival is unclear. We analyzed the impact of AT on overall (OS) and recurrence free survival (RFS) in patients undergoing curative resection. Methods We reviewed patients with resected HC between 2000 and 2015 from the ten institutions participating in the U.S. Extrahepatic Biliary Malignancy Consortium. We analyzed the impact of AT on RFS and OS. The probability of RFS and OS were calculated in the method of Kaplan and Meier and analyzed using multivariate Cox regression analysis. Results A total of 249 patients underwent curative resection for HC. Patients who received AT and those who did not had similar demographic and preoperative features. In a multivariate Cox regression analysis, AT conferred a significant protective effect on OS (HR 0.58, P = 0.013), and this was maintained in a propensity matched analysis (HR 0.66, P = 0.033). The protective effect of AT remained significant when node negative patients were excluded (HR 0.28, P = 0.001), while it disappeared (HR 0.76, P = 0.260) when node positive patients were excluded. Conclusions AT should be strongly considered after curative‐intent resection for HC, particularly in patients with node positive disease.