Jung JH, Lee HJ, Lee HS, Jo JH, Cho IR, Chung MJ, Park JY, Park SW, Song SY, Bang S. Benefit of neoadjuvant concurrent chemoradiotherapy for locally advanced perihilar cholangiocarcinoma. World J Gastroenterol 2017; 23(18): 3301-3308 [PMID: 28566890 DOI: 10.3748/wjg.v23.i18.3301]
Corresponding Author of This Article
Seungmin Bang, MD, PhD, Division of Gastroenterology, Department of Internal Medicine and Yonsei Institute of Gastroenterology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, South Korea. bang7028@yuhs.ac
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. May 14, 2017; 23(18): 3301-3308 Published online May 14, 2017. doi: 10.3748/wjg.v23.i18.3301
Benefit of neoadjuvant concurrent chemoradiotherapy for locally advanced perihilar cholangiocarcinoma
Jang Han Jung, Hyun Jik Lee, Hee Seung Lee, Jung Hyun Jo, In Rae Cho, Moon Jae Chung, Jeong Youp Park, Seung Woo Park, Si Young Song, Seungmin Bang
Jang Han Jung, Division of Gastroenterology, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, 7, Keunjaebong-gil, Hwaseong-si, Gyeonggi-do 18450, South Korea
Hyun Jik Lee, Hee Seung Lee, Jung Hyun Jo, In Rae Cho, Moon Jae Chung, Jeong Youp Park, Seung Woo Park, Si Young Song, Seungmin Bang, Division of Gastroenterology, Department of Internal Medicine and Yonsei Institute of Gastroenterology, Yonsei University College of Medicine, Seoul 03722, South Korea
Author contributions: Jung JH and Bang S contributed study design, data analysis and writing of the manuscript; Lee HJ, Lee HS, Jo JH and Cho IR contributed data analysis; Chung MJ, Park JY, Park SW and Song SY contributed to draft the manuscript and helped the literature review.
Institutional review board statement: The institutional review board of Severance Hospital approves this study (IRB 2016-2480-001).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Seungmin Bang, MD, PhD, Division of Gastroenterology, Department of Internal Medicine and Yonsei Institute of Gastroenterology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, South Korea. bang7028@yuhs.ac
Telephone: +82-2-22281995 Fax: +82-2-22281995
Received: February 6, 2017 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 Processing time: 97 Days and 14.9 Hours
Abstract
AIM
To clarify the role of neoadjuvant concurrent chemoradiotherapy (NACCRT) followed by surgical resection for localized or locally advanced perihilar cholangiocarcinoma (CCA).
METHODS
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.
RESULTS
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).
CONCLUSION
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.
