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Multimodality therapy for locoregional extrahepatic cholangiocarcinoma: a population-based analysis.

Publication ,  Journal Article
Fuller, CD; Wang, SJ; Choi, M; Czito, BG; Cornell, J; Welzel, TM; McGlynn, KA; Luh, JY; Thomas, CR
Published in: Cancer
November 15, 2009

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.

Duke Scholars

Published In

Cancer

DOI

ISSN

0008-543X

Publication Date

November 15, 2009

Volume

115

Issue

22

Start / End Page

5175 / 5183

Location

United States

Related Subject Headings

  • Survival Analysis
  • Radiotherapy, Adjuvant
  • Oncology & Carcinogenesis
  • Middle Aged
  • Male
  • Humans
  • Female
  • Combined Modality Therapy
  • Cholangiocarcinoma
  • Bile Duct Neoplasms
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Fuller, C. D., Wang, S. J., Choi, M., Czito, B. G., Cornell, J., Welzel, T. M., … Thomas, C. R. (2009). Multimodality therapy for locoregional extrahepatic cholangiocarcinoma: a population-based analysis. Cancer, 115(22), 5175–5183. https://doi.org/10.1002/cncr.24572
Fuller, Clifton D., Samuel J. Wang, Mehee Choi, Brian G. Czito, John Cornell, Tania M. Welzel, Katherine A. McGlynn, Join Y. Luh, and Charles R. Thomas. “Multimodality therapy for locoregional extrahepatic cholangiocarcinoma: a population-based analysis.Cancer 115, no. 22 (November 15, 2009): 5175–83. https://doi.org/10.1002/cncr.24572.
Fuller CD, Wang SJ, Choi M, Czito BG, Cornell J, Welzel TM, et al. Multimodality therapy for locoregional extrahepatic cholangiocarcinoma: a population-based analysis. Cancer. 2009 Nov 15;115(22):5175–83.
Fuller, Clifton D., et al. “Multimodality therapy for locoregional extrahepatic cholangiocarcinoma: a population-based analysis.Cancer, vol. 115, no. 22, Nov. 2009, pp. 5175–83. Pubmed, doi:10.1002/cncr.24572.
Fuller CD, Wang SJ, Choi M, Czito BG, Cornell J, Welzel TM, McGlynn KA, Luh JY, Thomas CR. Multimodality therapy for locoregional extrahepatic cholangiocarcinoma: a population-based analysis. Cancer. 2009 Nov 15;115(22):5175–5183.
Journal cover image

Published In

Cancer

DOI

ISSN

0008-543X

Publication Date

November 15, 2009

Volume

115

Issue

22

Start / End Page

5175 / 5183

Location

United States

Related Subject Headings

  • Survival Analysis
  • Radiotherapy, Adjuvant
  • Oncology & Carcinogenesis
  • Middle Aged
  • Male
  • Humans
  • Female
  • Combined Modality Therapy
  • Cholangiocarcinoma
  • Bile Duct Neoplasms