Benefit of Adjuvant Radiotherapy Following Narrow-margin Hepatectomy in Patients with Intrahepatic Cholangiocarcinoma That Adhere to Major Vessels

Overview

Journal Cancer Manag Res

Publisher Dove Medical Press

Specialty Oncology

Date 2018 Oct 13

PMID 30310318

Citations 13

Authors

Xuan Zheng

Bo Chen

Jian-Xiong Wu

Angela Y Jia

Wei-Qi Rong

Li-Ming Wang

Fan Wu

Yu-Ting Zhao

Ye-Xiong Li

Wei-Hu Wang

Affiliations

Soon will be listed here.

Abstract

Purpose: To evaluate the role of adjuvant radiotherapy after narrow-margin (<1.0 cm) resection in patients with intrahepatic cholangiocarcinoma (ICC) adherent to major vessels.

Patients And Methods: This retrospective study included 70 ICC patients. Forty-nine patients received narrow-margin (<1.0 cm) hepatectomy and 21 patients underwent wide-margin (≥1.0 cm) hepatectomy (Group C). Twenty-six of 49 were treated with postoperative radiotherapy (Group A), while the remaining 23 did not receive radiotherapy (Group B). Clinical outcomes were compared in the 3 groups. Toxicities of radiotherapy were evaluated.

Results: With a median follow-up time of 42 months, the 3-year overall survival (OS) and disease-free survival rates were 55% and 44% for Group A, 20% and 10% for Group B, and 65% and 33% for Group C, respectively. The OS and disease-free survival in Groups A and C were comparable and improved compared to Group B (Group A vs B, =0.011 and =0.031; and Group C vs B, =0.031 and =0.105). Multivariate analysis showed that receiving narrow-margin resection only (adjusted hazard ratio: 3.73; 95% CI: 1.36-10.25; =0.001) was a significant poor prognostic risk factor of OS. Group B experienced more intrahepatic recurrence and extrahepatic recurrence than Groups A and C. For Groups A and B, the 3-year intrahepatic recurrence rates were 36% vs 67% (=0.133) and extrahepatic recurrence rates were 43% vs 65% (=0.007). Only 2 patients in Group A suffered from grade 3 toxicities. No patient developed classic or nonclassic radiation-induced liver disease.

Conclusion: Postoperative radiotherapy following narrow-margin hepatectomy seems to be efficacious and well-tolerated in patients with ICC adjacent to major vessels.

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