Abstract | BACKGROUND: METHODS: We queried the National Cancer Database to identify patients presenting with histologically confirmed clinical stage I to III intrahepatic cholangiocarcinoma between 2004 and 2016. Propensity scoring was used to develop matched cohorts of patients undergoing treatment with liver transplantation, surgical resection, or chemotherapy alone. Kaplan Meier methods were used to compare rates of overall survival. RESULTS: One thousand four hundred and eleven patients met inclusion criteria. Of these, 66 (4.7%) underwent liver transplantation, 461 (32.7%) underwent surgical resection, and 884 (62.6%) were treated with chemotherapy alone. On adjusted analysis, patients undergoing liver transplantation were more likely to be male (odds ratio 4.35, 95% confidence interval [0.12, 0.42]), have a Charlson Comorbidity Score ≥2 (odds ratio 3.11, 95% confidence interval [1.44, 6.57]), and to receive both neoadjuvant (odds ratio 2.78, 95% confidence interval [1.36,5.75], and adjuvant (odds ratio 1.94, 95% confidence interval [0.97, 3.87]) systemic therapy than those undergoing resection. On Kaplan Meier analysis, patients undergoing liver transplantation demonstrated rates of 5-year overall survival (36.1% vs 34.7%, P = .53) that were statistically identical to those for stage-matched and margin-matched patients undergoing resection but significantly better than those for stage-matched patients treated with systemic therapy alone (36.1% vs 5.3%, P < .0001). CONCLUSION:
|
Authors | Preston Kim, Michael Littau, Talia B Baker, Zaid Abdelsattar, Celsa Tonelli, Corinne Bunn, Sujay Kulshrestha, Fred A Luchette, Marshall S Baker |
Journal | Surgery
(Surgery)
Vol. 171
Issue 3
Pg. 741-746
(03 2022)
ISSN: 1532-7361 [Electronic] United States |
PMID | 34895770
(Publication Type: Journal Article)
|
Copyright | Published by Elsevier Inc. |
Topics |
- Aged
- Bile Duct Neoplasms
(mortality, pathology, surgery)
- Cholangiocarcinoma
(mortality, pathology, surgery)
- Databases, Factual
- Female
- Hepatectomy
- Humans
- Kaplan-Meier Estimate
- Liver Transplantation
- Male
- Middle Aged
- Neoplasm Staging
- Propensity Score
- Retrospective Studies
- Survival Rate
- Treatment Outcome
|