Retrospective study of overall survival impact of adjuvant chemotherapy for resected intrahepatic cholangiocarcinoma

Randomized data suggest improved survival with adjuvant chemotherapy for biliary tract cancers; however, subset analyses of intrahepatic cholangiocarcinoma (IHC) show limited survival benefit. Retrospective analysis of datasets of Duke University Medical Center (Durham, NC) and Memorial Sloan Kettering Cancer Center (New York, NY) and the National Cancer Database evaluated the impact of adjuvant chemotherapy on recurrence patterns and overall survival in patients with resected IHC. In the bi-institutional dataset, 347 patients underwent resection for IHC, and 149 patients (43%) received adjuvant chemotherapy. Recurrenc was observed in 222 patients (64%). Recurrence-free survival was worse in the group with adjuvant chemotherapy (p=0.04) although the liver was the most common site of recurrence in both groups. Median overall survival was 42 months in the group with adjuvant chemotherapy and 49 months in the group without chemotherapy (p=0.13). A similar analysis of 1159 resected IHCs from the National Cancer Database also demonstrated no association between adjuvant chemotherapy and overall survival (median 49 versus 57 months; p=0.1). The authors conclude that adjuvant chemotherapy after resection for IHC may not be associated with improved outcomes.