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Table of Contents
Vol. 58, No. 2, 2012
Issue release date: June 2012
Section title: Clinical Study
Chemotherapy 2012;58:134–141
(DOI:10.1159/000337289)

Chemotherapy for Inoperable Advanced or Metastatic Cholangiocarcinoma: Retrospective Analysis of 78 Cases in a Single Center over Four Years

Pracht M.a · Le Roux G.c · Sulpice L.c · Mesbah H.b · Manfredi S.d · Audrain O.b · Boudjema K.c · Raoul J.-L.e · Boucher E.a
aMedical Oncology Unit and bMedical Information Unit, Comprehensive Cancer Center Eugène Marquis, cDigestive and Hepatobiliary Surgery Division and dGastroenterology Unit, University Hospital Pontchaillou, Rennes, and eMedical Oncology Unit, Comprehensive Cancer Center Paoli Calmettes, Marseille, France

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Article / Publication Details

First-Page Preview
Abstract of Clinical Study

Received: August 22, 2011
Accepted: February 16, 2012
Published online: May 10, 2012
Issue release date: June 2012

Number of Print Pages: 8
Number of Figures: 0
Number of Tables: 4

ISSN: 0009-3157 (Print)
eISSN: 1421-9794 (Online)

For additional information: http://www.karger.com/CHE

Abstract

Background: Systemic chemotherapy is the treatment of choice for inoperable (advanced or metastatic) cholangiocarcinoma. According to phase II and III trials, regimens combining 5-fluorouracil (5FU) or gemcitabine with a platinum salt have provided an overall response rate of 12–50% with a median overall survival of 5–16 months. Methods: This was a retrospective analysis of 78 consecutive cases of inoperable cholangiocarcinoma treated by palliative chemotherapy from July 2005 to November 2009 in one center. We firstly aimed to evaluate the impact of palliative chemotherapy in terms of survival and secondly to analyze possible related prognostic factors. Results: This cohort included 25 female and 53 male patients, with a mean age of 60.8 ± 11.4 years. Intrahepatic and extrahepatic cholangiocarcinoma were observed in 57 and 21 patients, respectively. First-line chemotherapy regimens were as follows: gemcitabine (n = 7), gemcitabine plus oxaliplatin (with or without cetuximab; n = 62) and 5FU plus cisplatin (n = 9). None of the patients achieved a complete response. The partial response rate was 35.9% (27/78), and the stable disease rate was 26.9% (21/78), giving a disease control rate of 62.8%. At the time of this analysis, with a median follow-up of 18 months, 13 patients were survivors. Median overall survival was 10 months [95% confidence interval (CI) 7–12], and median progression-free survival was 7 months (95% CI 6–8). Upon univariate analysis, only the distribution of the disease was significantly linked with prognosis, with a median overall survival of 10 months (95% CI 10–24) for solitary tumors versus 7 months (95% CI 6–11) in the case of infiltrative or multifocal tumors (p = 0.039). Conclusion: The disease control rate, overall survival and progression free-survival in this single-center retrospective study were in agreement with earlier reports. Specific features of this cohort were a large proportion of cholangiocarcinoma with associated cirrhosis (n = 30/78, 38.5%), mostly intrahepatic (n = 25/30, 83.5%). This confirms the increasing incidence of intrahepatic localization and the epidemiological link recently reported between intrahepatic biliary tract carcinoma and cirrhosis.

© 2012 S. Karger AG, Basel


Article / Publication Details

First-Page Preview
Abstract of Clinical Study

Received: August 22, 2011
Accepted: February 16, 2012
Published online: May 10, 2012
Issue release date: June 2012

Number of Print Pages: 8
Number of Figures: 0
Number of Tables: 4

ISSN: 0009-3157 (Print)
eISSN: 1421-9794 (Online)

For additional information: http://www.karger.com/CHE


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Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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