Adjuvant concurrent chemoradiation therapy in patients with microscopic residual tumor after curative resection for extrahepatic cholangiocarcinoma
- Authors
- Lee, J.; Kang, S. H.; Noh, O. K.; Chun, M.; Oh, Y. -T.; Kim, B. -W.; Kim, S. -W.
- Issue Date
- 8월-2018
- Publisher
- SPRINGER-VERLAG ITALIA SRL
- Keywords
- Extrahepatic cholangiocarcinoma; Concurrent chemoradiation therapy; Positive surgical margin; Survival
- Citation
- CLINICAL & TRANSLATIONAL ONCOLOGY, v.20, no.8, pp.1011 - 1017
- Indexed
- SCIE
SCOPUS
- Journal Title
- CLINICAL & TRANSLATIONAL ONCOLOGY
- Volume
- 20
- Number
- 8
- Start Page
- 1011
- End Page
- 1017
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/73832
- DOI
- 10.1007/s12094-017-1815-y
- ISSN
- 1699-048X
- Abstract
- We investigated the role of adjuvant concurrent chemoradiation therapy (CCRT) in patients with a microscopically positive resection margin (R1) after curative resection for extrahepatic cholangiocarcinoma (EHCC). A total of 84 patients treated with curative resection for EHCC were included. Fifty-two patients with negative resection margins did not receive any adjuvant treatments (R0 + S group). The remaining 32 patients with microscopically positive resection margins received either adjuvant CCRT (R1 + CCRT group, n = 19) or adjuvant radiation therapy (RT) alone (R1 + RT group, n = 13). During the median follow-up period of 26 months, the 2-year locoregional recurrence-free survival (LRRFS), disease-free survival (DFS), and overall survival rates (OS) were: 81.8, 62.6, and 61.5% for R0 + S group; 71.8, 57.8, and 57.9% for R1 + CCRT group; and 16.8, 9.6, and 15.4% for R1 + RT group, respectively. Multivariate analysis revealed that the R1 + CCRT group did not show any significant difference in survival rates compared with the R0 + S group. The R1 + RT group had lower LRRFS [hazard ratio (HR) 3.008; p = 0.044], DFS (HR 2.364; p = 0.022), and OS (HR 2.417; p = 0.011) when compared with the R0 + S and R1 + CCRT group. A lack of significant survival difference between R0 + S group and R1 + CCRT group suggests that adjuvant CCRT ameliorates the negative effect of microscopic positive resection margin. In contrast, adjuvant RT alone is appeared to be inadequate for controlling microscopically residual tumor.
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Collections - College of Medicine > Department of Medical Science > 1. Journal Articles
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