In node-positive intrahepatic cholangiocarcinoma, be aggressive

  • HPB

  • curated by Jim Kling
  • Univadis Clinical Summaries
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Takeaway

  • After chemotherapy and surgery, there was no difference in survival among patients with clinically lymph node-positive (cLNP) and pathologically proved lymph node-positive (pLNP) intrahepatic cholangiocarcinoma.

Why this matters

  • The presence of lymph node metastasis should not be a contraindication for resection.

Study design

  • Retrospective analysis of records from the National Cancer Database (n=1023).
  • Funding: NIH.

Key results

  • 23% of patients underwent resection. 15% underwent resection with chemotherapy. 67% of chemotherapy was in the adjuvant setting, 33% neoadjuvant. There was no difference in OS based on chemotherapy sequence.
  • Median survival was 13.6 months.
  • There was no difference in survival between resection alone (12.5 months) and chemotherapy alone (11.9 months; P=.226).
  • Combination resection and chemotherapy was associated with longer survival (median, 22.5 months; P<.001>
  • A multivariate analysis showed combination of resection and chemotherapy improved survival (HR, 0.53; P<.001>
  • There was no survival difference among patients receiving chemotherapy and resection based on cLNP (22.5 months) vs pLNP status (19.3 months; P=.995).

Limitations

  • Retrospective analysis.