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Photodynamic therapy may provide a benefit over systemic chemotherapy among non‐surgically managed patients with extrahepatic cholangiocarcinoma
Author(s) -
Wu Lu,
Merath Katiuscha,
Farooq Ayesha,
Hyer J. Madison,
Tsilimigras Diamantis I,
Paredes Anghela Z.,
Mehta Rittal,
Sahara Kota,
Shen Feng,
Pawlik Timothy M.
Publication year - 2020
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.25773
Subject(s) - medicine , chemotherapy , hazard ratio , propensity score matching , confidence interval , photodynamic therapy , cancer , oncology , surgery , gastroenterology , chemistry , organic chemistry
Background Systemic chemotherapy is the standard treatment for patients with unresectable extrahepatic cholangiocarcinoma (ECC), however, the survival benefit of chemotherapy is limited. Photodynamic therapy (PDT) has been associated with improved survival among patients with advanced ECC, yet utilization of PDT remains low. We sought to compare the outcomes of patients with unresectable ECC following treatment with PDT versus chemotherapy. Methods A review of the National Cancer Database was conducted to identify patients with ECC who were nonsurgically managed between 2004 and 2013. Overall survival (OS) of patients receiving PDT vs systemic chemotherapy was compared using propensity score matching. Results After propensity matching (PDT, n = 59; chemotherapy, n = 177), 5‐year OS was 17.6% (95% confidence interval [CI], 9.0%‐28.6%) among patients who underwent PDT vs 3.8% (95%CI, 0.4%‐14.0%) among patients receiving chemotherapy ( P < .001). On multivariable analysis PDT was associated with an OS benefit (hazard ratio, 0.72; 95%CI, 0.52‐0.998; P = .048). Subset analysis of patients receiving PDT only (n = 45) and patients receiving chemotherapy demonstrated similar results. In subset analysis of patients undergoing PDT‐only vs PDT‐chemotherapy, OS was comparable. Conclusion PDT was associated with a survival benefit compared with chemotherapy alone among patients with unresectable ECC.