PMID- 35284111
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20221117
IS  - 2078-6891 (Print)
IS  - 2219-679X (Electronic)
IS  - 2078-6891 (Linking)
VI  - 13
IP  - 1
DP  - 2022 Feb
TI  - Clinical outcomes for hilar and extrahepatic cholangiocarcinoma with adjuvant, 
      definitive, or liver transplant-based neoadjuvant chemoradiotherapy strategies: a 
      single-center experience.
PG  - 288-297
LID - 10.21037/jgo-21-615 [doi]
AB  - BACKGROUND: We report our experience with 3 strategies for treating hilar and 
      extrahepatic cholangiocarcinoma (CCA) including chemoradiotherapy: neoadjuvant 
      chemoradiotherapy (nCRT) and orthotopic liver transplant, surgical resection and 
      adjuvant chemoradiotherapy (aCRT), and definitive chemoradiotherapy (dCRT). 
      METHODS: We included patients treated from 1998 through 2019. Kaplan-Meier 
      estimates, log-rank testing, and univariate/multivariate Cox models were used to 
      assess outcomes (local progression-free survival, disease-free survival, and 
      overall survival). RESULTS: Sixty-five patients (nCRT, n=20; aCRT, n=16; dCRT, 
      n=29) met inclusion criteria [median (range) age 65 years (27-84 years)]. Median 
      posttreatment follow-up was 19.1 months (0.8-164.8 months) for all patients and 
      38.6, 24.3, and 9.0 months for the nCRT, aCRT, and dCRT groups, respectively. At 
      3 and 5 years, overall survival was 78% and 59% for the nCRT group; 47% and 35%, 
      aCRT group; and 11% and 0%, dCRT group. Compared with the dCRT group, the nCRT 
      group (hazard ratio =0.13, 95% CI: 0.05-0.33) and the aCRT group (hazard ratio 
      =0.29, 95% CI: 0.14-0.64) had significantly improved overall survival (P<0.001). 
      The 5-year local progression-free survival (50% nCRT vs. 30% aCRT vs. 0% dCRT, 
      P<0.001) and 5-year disease-free survival (61% nCRT vs. 30% aCRT vs. 0% dCRT, 
      P=0.01) were significantly better for strategies combined with surgery. 
      CONCLUSIONS: Outcomes for patients with extrahepatic CCA were superior for those 
      who underwent nCRT/orthotopic liver transplant or postsurgical aCRT than for 
      patients treated with dCRT. The excellent outcomes after nCRT/orthotopic liver 
      transplant provide additional independent data supporting the validity of this 
      strategy. The poor survival of patients treated with dCRT highlights a need for 
      better therapies when surgery is not possible.
CI  - 2022 Journal of Gastrointestinal Oncology. All rights reserved.
FAU - Laughlin, Brady S
AU  - Laughlin BS
AD  - Mayo Clinic School of Graduate Medical Education, Mayo Clinic College of Medicine 
      and Science, Phoenix, Arizona, USA.
FAU - Petersen, Molly M
AU  - Petersen MM
AD  - Clinical Trials and Biostatistics, Mayo Clinic, Scottsdale, Arizona, USA.
FAU - Yu, Nathan Y
AU  - Yu NY
AD  - Mayo Clinic School of Graduate Medical Education, Mayo Clinic College of Medicine 
      and Science, Phoenix, Arizona, USA.
FAU - Anderson, Justin D
AU  - Anderson JD
AD  - Mayo Clinic School of Graduate Medical Education, Mayo Clinic College of Medicine 
      and Science, Phoenix, Arizona, USA.
FAU - Rule, William G
AU  - Rule WG
AD  - Department of Radiation Oncology, Mayo Clinic Hospital, Phoenix, Arizona, USA.
FAU - Borad, Mitesh J
AU  - Borad MJ
AD  - Division of Hematology and Medical Oncology, Mayo Clinic Hospital, Phoenix, 
      Arizona, USA.
FAU - Aqel, Bashar A
AU  - Aqel BA
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic Hospital, Phoenix, 
      Arizona, USA.
AD  - Transplant Center, Mayo Clinic Hospital, Phoenix, Arizona, USA.
FAU - Sonbol, Mohamad B
AU  - Sonbol MB
AD  - Division of Hematology and Medical Oncology, Mayo Clinic Hospital, Phoenix, 
      Arizona, USA.
FAU - Mathur, Amit K
AU  - Mathur AK
AD  - Transplant Center, Mayo Clinic Hospital, Phoenix, Arizona, USA.
AD  - Division of Transplant and Hepatobiliary Surgery, Mayo Clinic Hospital, Phoenix, 
      Arizona, USA.
FAU - Moss, Adyr A
AU  - Moss AA
AD  - Transplant Center, Mayo Clinic Hospital, Phoenix, Arizona, USA.
AD  - Division of Transplant and Hepatobiliary Surgery, Mayo Clinic Hospital, Phoenix, 
      Arizona, USA.
FAU - Bekaii-Saab, Tanios S
AU  - Bekaii-Saab TS
AD  - Division of Hematology and Medical Oncology, Mayo Clinic Hospital, Phoenix, 
      Arizona, USA.
FAU - Ahn, Daniel H
AU  - Ahn DH
AD  - Division of Hematology and Medical Oncology, Mayo Clinic Hospital, Phoenix, 
      Arizona, USA.
AD  - Mayo Clinic Cancer Center, Mayo Clinic Hospital, Phoenix, Arizona, USA.
FAU - DeWees, Todd A
AU  - DeWees TA
AD  - Clinical Trials and Biostatistics, Mayo Clinic, Scottsdale, Arizona, USA.
AD  - Department of Radiation Oncology, Mayo Clinic Hospital, Phoenix, Arizona, USA.
FAU - Sio, Terence T
AU  - Sio TT
AD  - Department of Radiation Oncology, Mayo Clinic Hospital, Phoenix, Arizona, USA.
FAU - Ashman, Jonathan B
AU  - Ashman JB
AD  - Department of Radiation Oncology, Mayo Clinic Hospital, Phoenix, Arizona, USA.
LA  - eng
PT  - Journal Article
PL  - China
TA  - J Gastrointest Oncol
JT  - Journal of gastrointestinal oncology
JID - 101557751
CIN - J Gastrointest Oncol. 2022 Oct;13(5):2696-2698. PMID: 36388645
PMC - PMC8899753
OTO - NOTNLM
OT  - Cholangiocarcinoma (CCA)
OT  - extrahepatic cholangiocarcinoma (extrahepatic CCA)
OT  - hilar cholangiocarcinoma (hilar CCA)
OT  - liver transplant
OT  - neoadjuvant chemoradiation
COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure 
      form (available at 
      https://jgo.amegroups.com/article/view/10.21037/jgo-21-615/coif). DHA is an 
      advisor for Genentech, Eisai, Advanced Accelerator Applications, Exelixis, and 
      Daiichi Sankyo. TTS provides strategic and scientific recommendations as a member 
      of the Advisory Board and speaker for Novocure, Inc., which is not in any way 
      associated with the content presented in this manuscript. TSBS receives research 
      funding from Agios, Arys, Arcus, Atreca, Boston Biomedical, Bayer, Amgen, Merck, 
      Celgene, Lilly, Ipsen, Clovis, Seattle Genetics, Genentech, Novartis, Mirati, 
      Merus, Abgenomics, Incyte, Pfizer, and BMS; has consulting relationships with 
      Ipsen, Arcus, Array Biopharma, Pfizer, Seattle Genetics, Bayer, Genentech, 
      Incyte, Merck, Stemline, AbbVie, Boehringer Ingelheim, Janssen, Eisai, Daichii 
      Sankyo, Natera, TreosBio, Celularity, Exact Science, Sobi, Beigene, Kanaph, 
      Xilis, Astra Zeneca, and Foundation Medicine; participates on the Data Safety 
      Monitoring Boards of Fibrogen, Suzhou Kintor, Astra Zeneca, Exelixis, Lilly, 
      PanCan, and 1Globe; is a member of the Scientific Advisory Boards of Imugene, 
      Immuneering, and Panbela Therapeutics; and has the following patents pending: 
      WO/2018/183488 and WO/2019/055687. The other authors have no conflicts of 
      interest to declare.
EDAT- 2022/03/15 06:00
MHDA- 2022/03/15 06:01
PMCR- 2022/02/01
CRDT- 2022/03/14 05:58
PHST- 2021/09/21 00:00 [received]
PHST- 2022/01/11 00:00 [accepted]
PHST- 2022/03/14 05:58 [entrez]
PHST- 2022/03/15 06:00 [pubmed]
PHST- 2022/03/15 06:01 [medline]
PHST- 2022/02/01 00:00 [pmc-release]
AID - jgo-13-01-288 [pii]
AID - 10.21037/jgo-21-615 [doi]
PST - ppublish
SO  - J Gastrointest Oncol. 2022 Feb;13(1):288-297. doi: 10.21037/jgo-21-615.