Neoadjuvant therapy use and association with postoperative outcomes and overall survival in patients with extrahepatic cholangiocarcinoma.

التفاصيل البيبلوغرافية
العنوان:	Neoadjuvant therapy use and association with postoperative outcomes and overall survival in patients with extrahepatic cholangiocarcinoma.
المؤلفون:	Silver CM; Surgical Outcomes and Quality Improvement Center, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA., Joung RH; Surgical Outcomes and Quality Improvement Center, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.; Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA., Logan CD; Surgical Outcomes and Quality Improvement Center, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.; Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA., Benson AB; Division of Hematology and Oncology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.; Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, Illinois, USA., Mahalingam D; Division of Hematology and Oncology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA., D'Angelica MI; Department of Surgery, Memorial Sloane Kettering Cancer Center, New York, New York, USA., Bentrem DJ; Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA., Yang AD; Surgical Outcomes and Quality Improvement Center, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.; Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA., Bilimoria KY; Surgical Outcomes and Quality Improvement Center, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.; Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA., Merkow RP; Surgical Outcomes and Quality Improvement Center, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.; Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
المصدر:	Journal of surgical oncology [J Surg Oncol] 2023 Jan; Vol. 127 (1), pp. 90-98. Date of Electronic Publication: 2022 Oct 04.
نوع المنشور:	Journal Article
اللغة:	English
بيانات الدورية:	Publisher: Wiley-Liss Country of Publication: United States NLM ID: 0222643 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1096-9098 (Electronic) Linking ISSN: 00224790 NLM ISO Abbreviation: J Surg Oncol Subsets: MEDLINE
أسماء مطبوعة:	Publication: <2005-> : Hoboken, NJ : Wiley-Liss Original Publication: New York, Plenum.
مواضيع طبية MeSH:	Pancreatic Neoplasms/surgery , Cholangiocarcinoma/surgery , Bile Duct Neoplasms*/surgery, Humans ; Neoadjuvant Therapy ; Retrospective Studies ; Bile Ducts, Intrahepatic/pathology
مستخلص:	Background and Objectives: Evidence for neoadjuvant therapy (NAT) in extrahepatic cholangiocarcinoma (eCCA) is limited. Our objectives were to: (1) characterize treatment trends, (2) identify factors associated with receipt of NAT, and (3) evaluate associations between NAT and postoperative outcomes. Methods: Retrospective cohort study of the National Cancer Database (2004-2017). Multivariable logistic regression assessed associations between NAT and postoperative outcomes. Stratified analysis evaluated differences between surgery first, neoadjuvant chemotherapy, and neoadjuvant chemoradiation (CRT). Results: Among 8040 patients, 417 (5.2%) received NAT. NAT increased during the study period 2.9%-8.4% (p < 0.001). Factors associated with receipt of NAT included age <50 (vs. >75, odds ratio [OR] 4.32, p < 0.001) and stage 3 disease (vs. 1, OR 1.68, p = 0.01). Compared with surgery first, patients who received NAT had higher odds of R0 resection (OR 1.49, p = 0.01) and lower 30-day mortality (OR 0.51, p = 0.04). On stratified analysis, neoadjuvant chemotherapy was not associated with differences in any outcomes. However, neoadjuvant CRT was associated with improvement in R0 resection (OR 3.52, <0.001) and median survival (47.8 vs. 25.3 months, log-rank < 0.001) compared to surgery first. Conclusions: NAT, particularly neoadjuvant CRT, was associated with improved postoperative outcomes. These data suggest expanding the use of neoadjuvant CRT for eCCA. (© 2022 Wiley Periodicals LLC.)
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معلومات مُعتمدة:	P30 CA008748 United States CA NCI NIH HHS; T32 CA247801 United States CA NCI NIH HHS; T37 MD014248 United States MD NIMHD NIH HHS
فهرسة مساهمة:	Keywords: management trends; neoadjuvant chemoradiation; neoadjuvant chemotherapy
تواريخ الأحداث:	Date Created: 20221004 Date Completed: 20221207 Latest Revision: 20240102
رمز التحديث:	20240102
مُعرف محوري في PubMed:	PMC9729397
DOI:	10.1002/jso.27112
PMID:	36194064
قاعدة البيانات:	MEDLINE

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تدمد:	1096-9098
DOI:	10.1002/jso.27112