Published online May 14, 2017. doi: 10.3748/wjg.v23.i18.3301
Peer-review started: February 8, 2017
First decision: February 23, 2017
Revised: March 18, 2017
Accepted: April 12, 2017
Article in press: April 12, 2017
Published online: May 14, 2017
To clarify the role of neoadjuvant concurrent chemoradiotherapy (NACCRT) followed by surgical resection for localized or locally advanced perihilar cholangiocarcinoma (CCA).
We retrospectively reviewed 57 patients who underwent surgical resection with or without NACCRT for perihilar CCA; 12 patients received NACCRT and 45 patients did not received NACCRT. Patients with locally advanced perihilar CCA requiring NACCRT were defined as follows: (1) a mass involving unilateral branches of the portal vein or hepatic artery with insufficient volume of the anticipated remnant lobe; or (2) an infiltrating mass in the main portal vein that was too long for reconstruction, identified at preoperative staging.
The median disease-free survival (DFS) durations of the neoadjuvant and non-neoadjuvant CCRT groups were 26.0 and 15.1 mo, respectively (P = 0.91). The median overall survival (OS) durations of the neoadjuvant and non-neoadjuvant CCRT groups were 32.9 and 27.1 mo, respectively (P = 0.26). The NACCRT group showed a downstaging tendency compared to the non-NACCRT group as compared with the tumor stage confirmed by histological examination after surgery and the tumor stage confirmed by imaging test at the time of diagnosis (P = 0.01).
NACCRT does not prolong DFS and OS in localized or locally advanced perihilar CCA. However, NACCRT may allow tumor downstaging and improve tumor resectability.
Core tip: This study is a retrospective study to clarify the role of neoadjuvant concurrent chemoradiotherapy (NACCRT) followed by surgical resection for locally advanced perihilar cholangiocarcinoma (CCA). The median disease free survival (DFS) durations of the neoadjuvant and non-neoadjuvant group were 26.0 and 15.1 mo, respectively (P = 0.91). The median overall survival (OS) durations of the neoadjuvant and non-neoadjuvant groups were 32.9 and 27.1 mo, respectively (P = 0.26). However, the NACCRT group showed a downstaging tendency compared to the non-NACCRT group (P = 0.01). This paper will be helpful in the treatment plan for patients with locally advanced perihilar cholangiocarcinoma, especially NACCRT.