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01-08-2009 | Original Article

Gemcitabine-Based Adjuvant Chemotherapy Improves Survival After Aggressive Surgery for Hilar Cholangiocarcinoma

Authors: Yoshiaki Murakami, Kenichiro Uemura, Takeshi Sudo, Yasuo Hayashidani, Yasushi Hashimoto, Hiroaki Nakamura, Akira Nakashima, Taijiro Sueda

Published in: Journal of Gastrointestinal Surgery | Issue 8/2009

Abstract

Background

The prognosis of hilar cholangiocarcinoma is dismal although aggressive surgery including major hepatectomy has been performed. The aim of this study was to clarify useful prognostic factors and the usefulness of gemcitabine-based adjuvant chemotherapy for patients with hilar cholangiocarcinoma who had undergone aggressive surgical resection.

Methods

Medical records of 42 patients with hilar cholangiocarcinoma who underwent surgical resection were reviewed retrospectively. Univariate and multivariate models were used to analyze the effect of various clinicopathological factors on long-term survival.

Results

Overall 1-, 3-, and 5-year survival rates of the 42 patients with hilar cholangiocarcinoma were 81%, 42%, and 30%, respectively (median survival time, 21.5 months). Univariate analysis revealed that adjuvant gemcitabine-based chemotherapy, tumor differentiation, lymph node metastasis, and surgical margin status were associated significantly with long-term survival (P < 0.05). Furthermore, use of a Cox proportional hazards regression model indicated that only adjuvant gemcitabine-based chemotherapy was a significant independent predictor of a favorable prognosis (P = 0.035). The toxicity of adjuvant gemcitabine-based chemotherapy was mild. Five-year actuarial survival rates of patients who did or did not receive adjuvant gemcitabine-based chemotherapy were 57% and 23%, respectively (P = 0.026).

Conclusions

Postoperative adjuvant gemcitabine-based chemotherapy may be a promising strategy to improve survival after surgical resection for hilar cholangiocarcinoma. A prospective randomized study should be done to confirm the results of this study.

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Title: Gemcitabine-Based Adjuvant Chemotherapy Improves Survival After Aggressive Surgery for Hilar Cholangiocarcinoma
Authors: Yoshiaki Murakami
Kenichiro Uemura
Takeshi Sudo
Yasuo Hayashidani
Yasushi Hashimoto
Hiroaki Nakamura
Akira Nakashima
Taijiro Sueda
Publication date: 01-08-2009
Publisher: Springer-Verlag
Published in: Journal of Gastrointestinal Surgery / Issue 8/2009
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-009-0900-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Gemcitabine-Based Adjuvant Chemotherapy Improves Survival After Aggressive Surgery for Hilar Cholangiocarcinoma

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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