Predictors of adjuvant treatment and survival in patients with intrahepatic cholangiocarcinoma who undergo resection

Abstract

BackgroundAdministration of adjuvant therapy (AT) in patients with intrahepatic cholangiocarcinoma (ICC) remains inconsistent despite recent trial data. This study investigates predictors of receipt of AT and survival. MethodsPatients with ICC who underwent resection were identified using the NCDB (2004–2014). Logistic regression and Cox analysis were used to determine predictors of AT and survival, respectively. “High-risk” was defined as positive margins/nodes or stage III/IVa disease. Results2813 patients were identified, of whom 42.3% received AT. Patients with positive margins, positive nodes, and higher stage tended to receive AT (p < 0.001). Black patients and patients with Medicare/Medicaid were less likely to receive AT. In “high-risk” patients, AT was associated with lower mortality (HR 0.66, 95% CI 0.56–0.78, p < 0.001). ConclusionsAT after ICC resection is associated with improved survival in patients with positive margins, positive nodes, and stage III/IVa disease. There are disparities and regional variations in the receipt of AT.