Neoadjuvant chemoradiotherapy before resection of perihilar cholangiocarcinoma: A systematic review.

Hepatobiliary & Pancreatic Diseases International : HBPD INT
Minas BaltatzisAjith K Siriwardena

Abstract

Treatment with neoadjuvant chemoradiotherapy followed by liver transplantation yields promising results in perihilar cholangiocarcinoma (PH-CCA). This study reviews the literature to assess whether there is evidence to justify modern phase II studies of neoadjuvant chemoradiotherapy prior to resection of PH-CCA. A systematic review of the literature for reports of patients undergoing resection of PH-CCA after neoadjuvant chemoradiotherapy was performed using MEDLINE and EMBASE databases for the period between 1990 and 2019. The keywords and MeSH headings "hilar cholangiocarcinoma", "Klatskin", "chemoradiotherapy" and "chemotherapy" were used. Data were extracted on demographic profile, disease staging, chemoradiotherapy protocols, complications and outcome. Risks of bias were assessed using Cochrane methodology. There were seven reports on this topic, with median recruitment period of 14 (range 4-31) years. The total number of patients in these studies was 87. Interval from completion of neoadjuvant treatment to surgery varied from 3 days to 6 months. Resection was by hepatectomy with three studies reporting an R0 rate of 100%, 24% and 63%, respectively. Three studies reported histopathological evidence of prior treatment respo...Continue Reading

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Feb 13, 2021·Expert Review of Gastroenterology & Hepatology·Alexandra W AcherTimothy M Pawlik
Sep 16, 2021·Current Treatment Options in Oncology·Kimberly Washington, Flavio Rocha

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