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Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology

2000 - Neoadjuvant vs. adjuvant chemotherapy for cholangiocarcinoma: A propensity score matched analysis

Date

21 Oct 2018

Session

Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology

Topics

Cytotoxic Therapy

Tumour Site

Hepatobiliary Cancers

Presenters

Siddhartha Yadav

Citation

Annals of Oncology (2018) 29 (suppl_8): viii205-viii270. 10.1093/annonc/mdy282

Authors

S. Yadav1, H. Xie1, I.B. Riaz1, P. Sharma2, A. Mahipal1, R. McWilliams1

Author affiliations

  • 1 Department Of Oncology, Mayo Clinic, 55905 - Rochester/US
  • 2 Department Of Internal Medicine, Bridgeport Hospital, Yale New Haven Health System, Bridgeport/US
More

Resources

Abstract 2000

Background

The role of neoadjuvant-chemotherapy (NADJ) in cholangiocarcinoma is unknown. The purpose of this study is to evaluate whether NADJ improves overall survival (OS) in cholangiocarcinoma compared to adjuvant-chemotherapy (ADJ).

Methods

Using the National Cancer Database, we identified patients who underwent surgery and chemotherapy for stage I-III cholangiocarcinoma between 2006 and 2014. Patients with metastatic disease at diagnosis or unknown chemotherapy sequence with surgery were excluded. Propensity score for NADJ was calculated by multivariate logistic regression method. Matching with patients who received ADJ was then performed at the ratio of 1:3 using nearest neighbor method with a caliper width of 0.2. Covariates included in matching were: age at diagnosis, sex, race, insurance status, Charlson score, year of diagnosis, location of tumor, tumor grade, clinical stage, and use of radiation.

Results

1450 patients met our inclusion criteria, 299 (20.6%) received NADJ while 1151 (79.3%) received ADJ. The median age at diagnosis was 63 years. Factors associated with higher (p < 0.05) use of NADJ compared to ADJ were: ages <54 (35% vs. 23%), white race (91% vs. 86%), year of diagnosis 2012-2014 (48% vs. 40%), intrahepatic tumor location (74% vs. 54%), clinical stage I (46% vs. 38%), and unknown grade of tumor (36% vs. 14%). 279 patients in NADJ group were matched to 698 patients in ADJ group, with resulting standardized mean difference of < 0.1 for all covariates. In the matched cohort, patients who received NADJ had a significantly better OS compared to those who received ADJ (HR: 0.79; 95% CI: 0.65 – 0.96, p = 0.01). The 1- and 5-year OS was 85.9% and 42.1% respectively for NADJ, while it was 85.0% and 32.7% respectively for ADJ.

Conclusions

In this large national database study, NADJ compared to ADJ improved OS in a select group of patients with cholangiocarcinoma.

Clinical trial identification

Legal entity responsible for the study

Siddhartha Yadav.

Funding

Has not received any funding.

Editorial Acknowledgement

Disclosure

All authors have declared no conflicts of interest.

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