Neoadjuvant chemotherapy for initially unresectable intrahepatic cholangiocarcinoma.
Published: 31st August 2017
Authors: B. Le Roy, M. Gelli, G. Pittau, M.‐A. Allard, B. Pereira, B. Serji et al.
Locoregional extension of intrahepatic cholangiocarcinoma (ICC) at the time of diagnosis results in a low resectability rate and poor prognosis. The aim of this retrospective study was to assess the efficacy of neoadjuvant chemotherapy for locally advanced ICC.
All consecutive patients with ICC between 2000 and 2013 were included prospectively in a single‐centre database and analysed retrospectively. Patients with locally advanced ICC considered as initially unresectable received primary chemotherapy, followed by surgery in those with secondary resectability. Results of patients who underwent surgery for locally advanced ICC were compared with those of patients with initially resectable ICC treated by surgery alone.
A total of 186 patients were included in the study. Of 74 patients with locally advanced ICC, 39 (53 per cent) underwent secondary resection after a median of six chemotherapy cycles. Patients in this group were younger (
Patients with locally advanced ICC treated by surgery following neoadjuvant chemotherapy had similar short‐ and long‐term results to patients with initially resectable ICC who had surgery alone. Neoadjuvant chemotherapy as a first‐line treatment for locally advanced ICC may be an effective downstaging option, facilitating secondary resectability in patients with initially unresectable disease.Read more
You may also be interested in
Randomized clinical trial
Randomized clinical trial of laparoscopic ultrasonography before laparoscopic colorectal cancer resection. BJS 2017; 104: 1462-1469.
Authors: S. B. Ellebæk, C. W. Fristrup, C. Hovendal, N. Qvist, L. Bundgaard, S. Salomon et al.
Notes: No additional benefit
Randomized clinical trial
Randomized clinical trial of laparoscopic versus open pancreatoduodenectomy for periampullary tumours. BJS 2017; 104: 1443-1450.
Authors: C. Palanivelu, P. Senthilnathan, S. C. Sabnis, N. S. Babu, S. Srivatsan Gurumurthy, N. Anand Vijai et al.
Notes: Shorter stay
Authors: K. J. Roberts
Authors: A. J. Klompenhouwer, M. E. E. Bröker, M. G. J. Thomeer, M. P. Gaspersz, R. A. de Man, J. N. M. IJzermans et al.
Notes: Wait and see policy justified
Nationwide outcomes in patients undergoing surgical exploration without resection for pancreatic cancer. BJS 2017; 104: 1568-1577.
Authors: L. G. M. van der Geest, V. E. P. P. Lemmens, I. H. J. T. de Hingh, C. J. H. M. van Laarhoven, T. L. Bollen, C. Y. Nio et al.
Notes: Negative impacts
Impact of portal vein infiltration and type of venous reconstruction in surgery for borderline resectable pancreatic cancer. BJS 2017; 104: 1539-1548.
Authors: R. Ravikumar, C. Sabin, M. Abu Hilal, A. Al‐Hilli, S. Aroori, G. Bond‐Smith et al.
Notes: No difference between type of reconstruction
Trends in indications, complications and outcomes for venous resection during pancreatoduodenectomy. BJS 2017; 104: 1558-1567.
Authors: D. Kleive, M. A. Sahakyan, A. E. Berstad, C. S. Verbeke, I. P. Gladhaug, B. Edwin et al.
Notes: Severe complications, more reoperations
Authors: R. Green, S. C. Charman, T. Palser
Notes: Variation in compliance related to outcomes
Pancreatoduodenectomy with portal vein resection for distal cholangiocarcinoma. BJS 2017; 104: 1549-1557.
Authors: T. Maeta, T. Ebata, E. Hayashi, T. Kawahara, S. Mizuno, N. Matsumoto et al.
Notes: Poor survival despite portal vein resection
Average treatment effect of hepatic resection versus locoregional therapies for hepatocellular carcinoma.
Authors: A. Cucchetti, V. Mazzaferro, A. D. Pinna, C. Sposito, R. Golfieri, C. Serra et al.
Notes: Resection is better
Meta‐analysis of determinants of survival following treatment of recurrent hepatocellular carcinoma. BJS 2017; 104: 1433-1442.
Authors: S. Erridge, P. H. Pucher, S. R. Markar, G. Malietzis, T. Athanasiou, A. Darzi et al.
Notes: No evidence for best treatment