Faculty Collaboration Database

Neoadjuvant chemoradiation for extrahepatic cholangiocarcinoma. Am J Surg 1997 Dec;174(6):605-8; discussion 608-9

Date

12/31/1997

Pubmed ID

9409582

DOI

10.1016/s0002-9610(97)00203-1

Scopus ID

2-s2.0-0031470138 (requires institutional sign-in at Scopus site)   197 Citations

Abstract

BACKGROUND: The prognosis for patients with extrahepatic bile duct cancer remains poor. The purpose of this study was to evaluate our initial results with preoperative chemoradiation for extrahepatic cholangiocarcinoma, in the context of our experience with conventional treatment of this disease over the past 13 years.

METHODS: From 1983 through 1996, analysis of all patients treated for extrahepatic cholangiocarcinoma was performed.

RESULTS: Of 91 total patients, 51 had unresectable disease and 40 underwent resection. Median survival was significantly different for patients who underwent resection (22.2 months) versus those treated palliatively (10.7 months; P <0.0001). Nine patients underwent preoperative chemoradiation (5 perihilar, 4 distal) prior to resection. Three patients in the preoperative chemoradiation group had a pathologic complete response, while the remainder showed varying degrees of histologic response to treatment. The rate of margin-negative resection was 100% for the preoperative chemoradiation group versus 54% for the group who did not receive preoperative chemoradiation (P <0.01). There were no major intra-abdominal complications in the patients treated with preoperative chemoradiation.

CONCLUSIONS: These results suggest that preoperative chemoradiation for extrahepatic bile duct cancer can be performed safely, produces significant antitumor response, and may improve the ability to achieve tumor-free resection margins. Additional trials of preoperative chemoradiation are warranted.

Author List

McMasters KM, Tuttle TM, Leach SD, Rich T, Cleary KR, Evans DB, Curley SA

Author

Douglas B. Evans MD Chair, Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Bile Duct Neoplasms
Bile Ducts, Extrahepatic
Chemotherapy, Adjuvant
Cholangiocarcinoma
Female
Hepatectomy
Humans
Jejunostomy
Lymph Node Excision
Male
Middle Aged
Pancreaticoduodenectomy
Radiotherapy, Adjuvant
Retrospective Studies
Survival Analysis
Treatment Outcome