title: Adjuvant chemotherapy in resectable cholangiocarcinoma patients.
abstract: OBJECTIVE
  Cholangiocarcinoma patients usually have poor treatment outcome and a high mortality rate. The role of adjuvant chemotherapy (AC) is controversial. Our study aimed to evaluate benefits of AC in resectable cholangiocarcinoma patients.
  
  
  METHODS
  A retrospective study included 263 patients who underwent curative resection in Srinakarind University Hospital. These patients had pathological reports showing a clear margin (R0) or microscopic margin (R1) of lesion-free tissue.
  
  
  RESULTS
  There were 138 patients who received AC. This group had a significantly lower mean age than patients not receiving adjuvant chemotherapy (NAC) group (57.7 ± 8.5 vs 60.4 ± 9.0 years, P = 0.01). The level of serum albumin above 3 g/dL was more common in AC group than the NAC one (87.7% vs 79.2%, P = 0.04). Patients who received AC had significantly longer overall median survival time (21.6 vs 13.4 months, P = 0.01). Patients with a combination of gemcitabine and capecitabine regimen had the longest survival time (median overall survival time of gemcitabine and capecitabine 31.5, 5-fluorouracil and mitomycin 17.3, 5-fluorouracil alone 22.2, capecitabine alone 21.6, and gemcitabine alone 7.9 months, P = 0.02). Benefits of AC were likely to be found in patients who had high-risk features, that is, high level of carbohydrate antigen 19-9, advanced stage, T4 stage, lymph node involvement, and R1 margin.
  
  
  CONCLUSIONS
  AC significantly prolongs survival time in resectable cholangiocarcinoma patients, particularly in the high risk group.
authors.affiliation: Department of Medicine, Khon Kaen University, Khon Kaen, Thailand.
authors.forename: Kosin
authors.initials: K
authors.lastname: Wirasorn
authors.forename: Thundon
authors.initials: T
authors.lastname: Ngamprasertchai
authors.forename: Narong
authors.initials: N
authors.lastname: Khuntikeo
authors.forename: Ake
authors.initials: A
authors.lastname: Pakkhem
authors.forename: Piti
authors.initials: P
authors.lastname: Ungarereevittaya
authors.forename: Jarin
authors.initials: J
authors.lastname: Chindaprasirt
authors.forename: Aumkhae
authors.initials: A
authors.lastname: Sookprasert
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001650:Bile Duct Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D001653:Bile Ducts, Intrahepatic; D000069287:Capecitabine; D017024:Chemotherapy, Adjuvant; D018281:Cholangiocarcinoma / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D004341:Drug Evaluation / Q000379:methods; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000031:analogs & derivatives; D006801:Humans; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D000093542:Gemcitabine
chemical_list: D003841:Deoxycytidine; D016685:Mitomycin; D000069287:Capecitabine; D005472:Fluorouracil; D000093542:Gemcitabine
keywords: cholangiocarcinoma < hepatology; epidemiology < hepatology; liver surgery < hepatology