Neoadjuvant chemotherapy for resectable intrahepatic cholangiocarcinoma: short-term outcomes

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Abstract

Background. Neoadjuvant chemotherapy (NACT) is not included in standard treatment protocols for patients with intrahepatic cholangiocarcinoma (ICC).

Aim. To compare immediate treatment outcomes in ICC patients receiving NACT versus surgery alone.

Materials and methods. The retrospective analysis included patients who underwent surgery for ICC between 2010 and 2024. NACT-related complications were assessed using CTCAE v.5.0, treatment response was evaluated per the RECIST 1.1 criteria, and the impact of NACT on postoperative complications and likelihood of adjuvant chemotherapy (ACT) completion were analyzed.

Results. The surgery-only (control) group included 108 patients, while the NACT group included 49 patients. Grade III NACT-related complications developed in 2 (4.4 %) patients. Partial response (PR) to NACT was observed in 5 (10.2 %) patients, with stable disease was achieved in 40 (81.6 %) patients. R0 resection was achieved in 91 (84.3 %) patients in the surgery-only group and 47 (95.9 %) in the NACT group (p = 0.113). NACT did not affect the risk of severe postoperative complications (hazard ratio 0.482; 95 % confidence interval 0.183–1.268; p = 0.139). Patients receiving NACT completed ACT more frequently compared to control group: 76 (70.4 %) versus 43 (87.8 %), respectively (p = 0.026).

Conclusion. NACT demonstrated high safety but low PR rates and no impact on R0 resection achievement probability.

About the authors

A. Sh. Umirzokov

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Email: dr.alexp@gmail.com
ORCID iD: 0000-0001-9126-3153
Russian Federation, 24 Kashirskoe Shosse, Moscow, 115522

A. V. Korshak

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Email: dr.alexp@gmail.com
ORCID iD: 0009-0002-8236-2808
Russian Federation, 24 Kashirskoe Shosse, Moscow, 115522

S. N. Korchagina

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Email: dr.alexp@gmail.com
ORCID iD: 0009-0006-9275-4556
Russian Federation, 24 Kashirskoe Shosse, Moscow, 115522

V. N. Zhuykov

A.M. Granov Russian Research Center of Radiology and Surgical Technologies

Email: dr.alexp@gmail.com
ORCID iD: 0000-0003-1143-6654
Russian Federation, 70 Leningradskaya St., Pesochnyy, Saint Petersburg, 197758

V. I. Egorov

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia; Kazan State Medical University, Ministry of Health of Russia; M.Z. Sigal Republican Clinical Oncology Dispensary of Ministry of Health Care of Tatarstan Republic

Email: dr.alexp@gmail.com
ORCID iD: 0000-0002-6603-1390
Russian Federation, 24 Kashirskoe Shosse, Moscow, 115522; 49 Butlerova St., Kazan, 420012; 29 Sibirskiy Trakt, Kazan, 420029

D. M. Kantieva

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Email: dr.alexp@gmail.com
ORCID iD: 0000-0003-3953-0036
Russian Federation, 24 Kashirskoe Shosse, Moscow, 115522

I. V. Savchenko

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Email: dr.alexp@gmail.com
ORCID iD: 0000-0003-2142-661X
Russian Federation, 24 Kashirskoe Shosse, Moscow, 115522

A. V. Moiseenko

A.M. Granov Russian Research Center of Radiology and Surgical Technologies

Email: dr.alexp@gmail.com
ORCID iD: 0000-0002-1011-4533
Russian Federation, 70 Leningradskaya St., Pesochnyy, Saint Petersburg, 197758

Aleksandr N. Polyakov

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Author for correspondence.
Email: dr.alexp@gmail.com
ORCID iD: 0000-0001-5348-5011
Russian Federation, 24 Kashirskoe Shosse, Moscow, 115522

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