Resected intrahepatic cholangiocarcinoma: Is adjuvant chemotherapy associated with improved overall survival?

BACKGROUND

Recent randomized trials evaluating survival benefit to adjuvant chemotherapy (AC) in cholangiocarcinoma evaluate heterogeneous populations including patients with gallbladder cancer, extrahepatic, and intrahepatic cholangiocarcinoma (ICCA). The efficacy of AC in ICCA remains undefined.

METHODS

We queried the National Cancer Database for patients undergoing resection of localized ICCA between 2006 and 2017. Patients receiving AC were 1:1 propensity score matched for age, sex, race, comorbidities, insurance, stage, radiation, and resection margin to those undergoing resection alone. Kaplan-Meier (KM) methods were used to compare 5-year overall survival (OS) patterns for matched cohorts.

RESULTS

1312 patients underwent resection of ICCA; 489 (37.3 ​%) received AC. 411 patients undergoing AC were successfully matched to 411 undergoing surgery alone. Median OS was 40.8 months for patients treated with AC versus 32.0 months for those undergoing resection alone (p ​= ​0.151).

CONCLUSIONS

AC offers limited potential benefit to patients with resected ICCA.