Abstract 298P
Background
The management of cholangiocarcinoma (CCA) is constantly updated given existing evidence in order to establish practice guidelines. Here, we evaluate the outcomes of gemcitabine-based therapy versus non-gemcitabine-based therapy as neo-adjuvant for orthotopic liver transplant (OLT) recipients with cholangiocarcinoma.
Methods
In this retrospective study, CCA cases that underwent OLT at our center between January 2008 and March 2023 were identified. This cohort is stratified by systemic neoadjuvant therapy into two major cohorts Gemcitabine-Based Group (GBG) Vs. Non- Gemcitabine-Based Group (NGBG). Data are presented as mean±SD or median (IQR) for continuous measures, and n (%) for categorical measures. The primary endpoints were the overall survival post-OLT. A Kaplan-Meier analysis was performed to estimate the survival at different time points in the two groups, respectively.
Results
During this cohort, 76 patients with CCA underwent OLT. Of these, 27 patients either did not receive neoadjuvant therapy or diagnosed mixed with HCC were excluded. A total of 49 patients with CCA were analyzed (EHCCA 25 Vs. IHCCA 24), the majority were male (n=28) with a mean age of 54.79± 12.86 years at OLT. The GBG was 41 pts (23 with locoregional therapy/liver-directed therapy (LRT/LDT), 18 without LRT/LDT), and NGBG was 8 Pts (8 with LRT/LDT, 0 without LRT/LDT). The best response achieved to systemic therapy was complete response (CR) 11(22.45), partial response (PR) 22 (44.90), stable disease (SD)13 (26.53) and progression disease (PD) 3 (6.12). The median post-OLT follow-up was 4.05 years (IQR: 2.42-6.16 years). The systemic therapy discontinuation reasons were completion 29 (59.18), surgery 12 (24.49), and toxicity 8 (16.33). Overall survival (OS) at 1 year: 100% in the GBG, 87.5% (95% CI: 38.7%-98.1%) in NGBG. OS at 2 years: 97.4% (95% CI: 83.2%-99.6%) in the GBG, 62.5% (95% CI: 22.9%-86.1%) in the NGBG. OS at 3 years: 81.0% (95% CI: 64.2%-90.4%) in the GBG, 62.5% (95% CI: 22.9%-86.1%) in the NGBG.
Conclusions
Based on the previously described data, the GBG demonstrated improvement in outcomes compared to the NGBG in pts with CCA prior to OLT.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.