title: The effect of preoperative chemotherapy treatment in surgically treated intrahepatic cholangiocarcinoma patients-A multi-institutional analysis.
abstract: BACKGROUND
  While preoperative chemotherapy (pCT) is utilized in many intra-abdominal cancers, the use of pCT among patients with intrahepatic cholangiocarcinoma (ICC) remains ill defined. As such, the objective of the current study was to examine the impact of pCT among patients undergoing curative-intent resection for ICC.
  
  
  METHODS
  Patients who underwent hepatectomy for ICC were identified from a multi-institutional international cohort. The association between pCT with peri-operative and long-term clinical outcomes was assessed.
  
  
  RESULTS
  Of the 1 057 patients who were identified and met the inclusion criteria, 62 patients (5.9%) received pCT. These patients were noticed to have more advanced disease. Median OS (pCT:46.9 months vs no pCT:37.4 months; P = 0.900) and DFS (pCT: 34.1 months vs no pCT: 29.1 months; P = 0.909) were similar between the two groups. In a subgroup analysis of propensity-score matched patients, there was longer OS (pCT:46.9 months vs no pCT:29.4 months) and DFS (pCT:34.1 months vs no pCT:14.0 months); however this did not reach statistical significance (both P > 0.05).
  
  
  CONCLUSIONS
  In conclusion, pCT utilization among patients with ICC was higher among patients with more advanced disease. Short-term post-operative outcomes were not affected by pCT use and receipt of pCT resulted in equivalent OS and DFS following curative-intent resection.
authors.affiliation: Department of Surgery, Johns Hopkins Hospital, Baltimore, Maryland.|Department of Surgery, Erasmus Medical Center, Rotterdam, the Netherlands.
authors.forename: Stefan
authors.initials: S
authors.lastname: Buettner
authors.affiliation: Department of Surgery, Erasmus Medical Center, Rotterdam, the Netherlands.
authors.forename: Bas Groot
authors.initials: BG
authors.lastname: Koerkamp
authors.affiliation: Department of Surgery, Johns Hopkins Hospital, Baltimore, Maryland.
authors.forename: Aslam
authors.initials: A
authors.lastname: Ejaz
authors.affiliation: Department of Surgery, Erasmus Medical Center, Rotterdam, the Netherlands.
authors.forename: Florian E
authors.initials: FE
authors.lastname: Buisman
authors.affiliation: Department of Surgery, Johns Hopkins Hospital, Baltimore, Maryland.
authors.forename: Yuhree
authors.initials: Y
authors.lastname: Kim
authors.affiliation: Department of Surgery, Johns Hopkins Hospital, Baltimore, Maryland.
authors.forename: Georgios Antonios
authors.initials: GA
authors.lastname: Margonis
authors.affiliation: Fundeni Clinical Institute, Bucharest, Romania.
authors.forename: Sorin
authors.initials: S
authors.lastname: Alexandrescu
authors.affiliation: Curry Cabral Hospital, Lisbon, Portugal.
authors.forename: Hugo P
authors.initials: HP
authors.lastname: Marques
authors.affiliation: Curry Cabral Hospital, Lisbon, Portugal.
authors.forename: Jorge
authors.initials: J
authors.lastname: Lamelas
authors.affiliation: Ospedale San Raffaele, Milan, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Aldrighetti
authors.affiliation: Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: T Clark
authors.initials: TC
authors.lastname: Gamblin
authors.affiliation: Emory University, Atlanta, Georgia.
authors.forename: Shishir K
authors.initials: SK
authors.lastname: Maithel
authors.affiliation: University of Sydney, Sydney, Australia.
authors.forename: Carlo
authors.initials: C
authors.lastname: Pulitano
authors.affiliation: University of Virginia, Charlottesville, Virginia.
authors.forename: Todd W
authors.initials: TW
authors.lastname: Bauer
authors.affiliation: Eastern Hepatobiliary Surgery Hospital, Shanghai, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Shen
authors.affiliation: Stanford University, Stanford, California.
authors.forename: George A
authors.initials: GA
authors.lastname: Poultsides
authors.affiliation: University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
authors.forename: J Wallis
authors.initials: JW
authors.lastname: Marsh
authors.affiliation: Department of Surgery, Erasmus Medical Center, Rotterdam, the Netherlands.
authors.forename: Jan N M
authors.initials: JN
authors.lastname: IJzermans
authors.affiliation: Department of Surgery, Johns Hopkins Hospital, Baltimore, Maryland.
authors.forename: Timothy M
authors.initials: TM
authors.lastname: Pawlik
mesh_terms: D000368:Aged; D001650:Bile Duct Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic / Q000473:pathology / Q000601:surgery; D018281:Cholangiocarcinoma / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005260:Female; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods
keywords: intrahepatic cholangiocarcinoma; preoperative chemotherapy; prognostic factors; risk factors; survival