Neoadjuvant chemotherapy is associated with improved surviva
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Neoadjuvant chemotherapy in intrahepatic cholangiocarcinoma is associated with improved overall survival but not recurrence-free survival after accounting for both disease stage and surgical margin status. Neoadjuvant chemotherapy is not associated with increased odds of a major postoperative complication or odds of resection with negative margins.

In this study published by the American Journal of Transplantation, researchers sought to evaluate neoadjuvant chemotherapy (NAC) with oncologic outcomes in intrahepatic cholangiocarcinoma (ICC).

Investigators identified n?=?52 patients with ICC undergoing hepatectomy from 2004 to 2017. Oncologic outcomes were analyzed using Kaplan-Meier and multivariate Cox proportional hazard modeling.

The median patient age was 64-years. NAC was administered in ten patients, most commonly with gemcitabine-cisplatin. Median RFS and OS were 15 months. and 49 months, respectively. Controlling for stage and margins, NAC was independently associated with the improved OS but not RFS. NAC was not associated with major postoperative complications or R1 margins.

In conclusion, NAC in ICC may hold oncologic benefits beyond downstaging borderline resectable disease, such as identifying patients with favorable biology who are more likely to benefit from resection.

Source: https://doi.org/10.1016/j.amjsurg.2021.02.029
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