Surgery and combined transplant with chemotherapy improve survival for patients with liver limited and locally advanced intrahepatic cholangiocarcinoma: a seer database analysis

Presenter: Guergana Panayotova MD, MHS | Rutgers University Background: The precise impact of neoadjuvant chemotherapy for patients with intrahepatic cholangiocarcinoma (iCCA) remains unclear. While small, single center series suggest improved survival receiving followed by surgery, the overall to be elucidated. present study sought determine whether a multimodal treatment approach, including surgery or liver transplantation, offers advantage liver-limited, locally advanced iCCA. Methods: Surveillance, Epidemiology, and End Results (SEER) database from 2004-2014 was queried diagnosis code Only who are transplant candidates were considered (i.e. negative nodal status, no extrahepatic disease: T1-T3N0M0 AJCC 6th edition, T1-2N0M0 7th 8th edition). Demographics, tumor characteristics, outcomes evaluated. Patients stratified based on modality. P < 0.05 significant. Results: A total 1621 limited and/or iCCA identified. majority (55%) had T1 disease (AJCC Median alone + medical therapy 46 months, compared 5 months 13 therapy. Liver median 19 5-year (OS) 14%, which similar 27% 25% offered best survival, > 60 62% OS at years. Surgical significant (p70 yo [HR = 1.7, p 0.01], size >7cm 1.85, 0.04] stage (> 1.4, 0.03 ], >T2 1.9, p<0.0001]) significantly increased risk mortality. Conclusion: Liver-limited carries poor prognosis. Transplant plus chemotherapy/radiation results in patient may viable alternative otherwise unresectable disease. Prospective clinical trial data is necessary further establish role management cholangiocarcinoma.