Chemotherapy Prolongs Survival in Patients With Cholangiocarcinoma

Chemotherapy significantly prolongs survival in patients with metastatic cholangiocarcinoma (CCA), according to a study presented here on March 1 at Canadian Digestive Diseases Week 2013 (CDDW).

With overall incidence of CCAs low and mortality rates high, research is lacking on the true effect of chemotherapy on survival of patients with CCA.

Tahir M. Shaikh, MD, University of Ottawa, Ottawa, Ontario, and colleagues conducted a retrospective study evaluating data on 209 patients with CCA who were treated from 1998 to 2008.

Of the patients, 166 had adenocarcinomas; 17had stage 0 to 1 cancer; 99 had stage 2 to 3; and 93 had stage 4 cancer.

Of the patients, 162 received treatment (118 surgical resection [R0 and R1], 85 chemotherapy, and 33 radiation therapy.

The median overall survival was 2.1 months with no treatment, 12.4 months with treatment, 21.9 months with R0 surgical resection, and 10.9 with R1 surgical resection (P <.001).

The median survival among patients with surgical resection plus adjuvant chemotherapy was 22.2 months, compared with 21.9 months without adjuvant chemotherapy (P =.75). The median survival for R0 resection was 18.1 months versus 10.9 months for R1 resection (P =.10).

In patients with unresectable tumours, the median survival with chemotherapy was 10.7 months, compared with just 2.1 months without chemotherapy
(P <.05).

“CCAs are associated with poor survival if untreated,” the authors concluded.
“Complete surgical resection was associated with significantly improved
survival outcomes. Adjuvant chemotherapy in the setting of R0 resection did not
improve survival compared to surgical monotherapy.”

“In the setting of unresectable or metastatic CCA, survival was significantly
prolonged in patients who received palliative chemotherapy,” they added.
“Although not conclusive, these data suggests the use of adjuvant chemotherapy
in the setting resection with positive margins may also prolong survival.”