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Original Article
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Multimodality therapy for locoregional extrahepatic cholangiocarcinoma†‡
A population-based analysis
Article first published online: 27 JUL 2009
DOI: 10.1002/cncr.24572
Published 2009 American Cancer Society
Additional Information
How to Cite
Fuller, C. D., Wang, S. J., Choi, M., Czito, B. G., Cornell, J., Welzel, T. M., McGlynn, K. A., Luh, J. Y. and Thomas, C. R. (2009), Multimodality therapy for locoregional extrahepatic cholangiocarcinoma. Cancer, 115: 5175–5183. doi: 10.1002/cncr.24572
- †
Preliminary versions of these analyses were presented at the American Society of Therapeutic Radiology and Oncology Annual Meeting, Los Angeles, California, October 28-November 1, 2007 and the American Radium Society Meeting, Vancouver, British Columbia, Canada, April 25-29, 2009.
- ‡
This article is a US Government work and, as such, is in the public domain in the United States of America.
Publication History
- Issue published online: 3 NOV 2009
- Article first published online: 27 JUL 2009
- Manuscript Accepted: 3 FEB 2009
- Manuscript Revised: 28 JAN 2009
- Manuscript Received: 9 OCT 2008
- Abstract
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Keywords:
- cholangiocarcinoma;
- bile duct cancer;
- radiotherapy;
- surgery;
- lognormal survival
Abstract
BACKGROUND:
Although surgical resection is the mainstay of treatment for extrahepatic cholangiocarcinoma, the majority of patients present with advanced disease. Due in part to numeric rarity, the optimum role of radiotherapy (RT) for extrahepatic cholangiocarcinoma, as well as its relative benefit, is an area of debate. The specific aim of this series was to estimate survival for extrahepatic cholangiocarcinoma patients receiving surgery and adjuvant RT using a robust population-based data set.
METHODS:
Data were extracted from the Surveillance, Epidemiology, and End Results (SEER) limited-use data set for selected extrahepatic cholangiocarcinoma cases. Lognormal multivariate survival analysis was implemented to estimate survival for patients for treatment cohorts based on extent of surgical intervention and RT.
RESULTS:
Parametric estimated median survival for patients receiving total/radical resection + RT was 26 months; it was 25 months for total/radical resection alone, 25 months for subtotal/debulking resection + RT, 21 months for subtotal/debulking resection, 12 months for RT alone, and 9 months for those not receiving surgery or RT. Parametric multivariate analysis revealed age, American Joint Committee on Cancer Stage, grade, and surgical/radiation regimen as statistically significant covariates with survival. Surgery alone and adjuvant RT cohorts demonstrated evidence of improved survival compared with no treatment; comparatively, RT alone was associated with survival decrement. Early improvement in survival in adjuvant cohorts was not observed at later time points.
CONCLUSIONS:
Survival estimates using SEER data suggest an early survival advantage for adjuvant RT for patients with locoregional extrahepatic cholangiocarcinoma. Although future prospective series are needed to confirm these observations, SEER data represent the largest domestic population-based extrahepatic cholangiocarcinoma cohort, and may provide useful baseline survival estimates for future studies. Cancer 2009. Published 2009 by the American Cancer Society.