6533b7d8fe1ef96bd126a463

RESEARCH PRODUCT

The Addition of Transarterial Chemoembolization to Palliative Chemotherapy Extends Survival in Intrahepatic Cholangiocarcinoma

Felix HahnThomas ThomaidisJens U. MarquardtJens U. MarquardtMarkus MoehlerMichael B. PittonLukas MüllerSimon Johannes GairingFabian BartschPeter R. GalleArndt WeinmannFelix TholRoman KloecknerMarcus-alexander WörnsCarolin CzaudernaCarolin CzaudernaFriedrich Foerster

subject

medicine.medical_specialtycombined modality therapymedicine.medical_treatmentchemotherapyGastroenterologysurvivalArticle03 medical and health sciences0302 clinical medicineInternal medicinemedicineCombined Modality TherapyStage (cooking)chemoembolizationIntrahepatic CholangiocarcinomaChemotherapyPerformance statusbusiness.industryIncidence (epidemiology)RGeneral MedicinePalliative chemotherapy030220 oncology & carcinogenesisPropensity score matchingMedicine030211 gastroenterology & hepatologybusinesscholangiocarcinoma

description

Incidence and mortality of intrahepatic cholangiocarcinoma (iCCA) have been increasing continuously. Recent studies suggest that the combination of palliative chemotherapy (pCTX) and transarterial chemoembolization (TACE) improves overall survival (OS). This study aimed to evaluate the outcome of patients treated with TACE and pCTX in unresectable iCCA at our tertiary care center. A group of 14 patients was treated with both pCTX and TACE. The non-randomized control group of 59 patients received pCTX alone. Patients received a median of two pCTX lines in both groups. Those treated with TACE underwent a median number of 3.5 sessions. Median OS from the time of unresectability was 26.2 months in the pCTX + TACE group versus 13.1 months in the pCTX group (p = 0.008). Controlling for albumin, bilirubin, ECOG (Eastern Cooperative Oncology Group) performance status, and UICC (Union for International Cancer Control) stage, the addition of TACE still conferred an OS benefit of 12.95 months (p = 0.014). A propensity score matching analysis yielded an OS benefit of 14 months from the time of unresectability for the pCTX + TACE group (p = 0.020). The addition of TACE to pCTX may provide an OS benefit for patients with unresectable iCCA. Thus, patients with liver-dominant iCCA undergoing standard-of-care pCTX should be considered for additional treatment with TACE.

10.3390/jcm10122732http://dx.doi.org/10.3390/jcm10122732