Photodynamic therapy may provide a benefit over systemic chemotherapy among non-surgically managed patients with extrahepatic cholangiocarcinoma
Lu Wu MD
Department of Hepatic Surgery, Eastern Hepato-biliary Surgery Hospital, Second Military Medical University, Shanghai, China
Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, Ohio
Search for more papers by this authorKatiuscha Merath MD
Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, Ohio
Search for more papers by this authorAyesha Farooq MBBS
Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, Ohio
Search for more papers by this authorJ. Madison Hyer MS
Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, Ohio
Search for more papers by this authorDiamantis I Tsilimigras MD
Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, Ohio
Search for more papers by this authorAnghela Z. Paredes MD
Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, Ohio
Search for more papers by this authorRittal Mehta MPH, BDS
Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, Ohio
Search for more papers by this authorKota Sahara MD
Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, Ohio
Search for more papers by this authorFeng Shen MD
Department of Hepatic Surgery, Eastern Hepato-biliary Surgery Hospital, Second Military Medical University, Shanghai, China
Search for more papers by this authorCorresponding Author
Timothy M. Pawlik MD, MPH, PhD, FACS
Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, Ohio
Correspondence Timothy M. Pawlik, MD, MPH, PhD, FACS, FRACS (Hon), Professor and Chair, Department of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, 395W. 12th Ave, Suite 670.
Email: [email protected]
Search for more papers by this authorLu Wu MD
Department of Hepatic Surgery, Eastern Hepato-biliary Surgery Hospital, Second Military Medical University, Shanghai, China
Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, Ohio
Search for more papers by this authorKatiuscha Merath MD
Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, Ohio
Search for more papers by this authorAyesha Farooq MBBS
Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, Ohio
Search for more papers by this authorJ. Madison Hyer MS
Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, Ohio
Search for more papers by this authorDiamantis I Tsilimigras MD
Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, Ohio
Search for more papers by this authorAnghela Z. Paredes MD
Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, Ohio
Search for more papers by this authorRittal Mehta MPH, BDS
Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, Ohio
Search for more papers by this authorKota Sahara MD
Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, Ohio
Search for more papers by this authorFeng Shen MD
Department of Hepatic Surgery, Eastern Hepato-biliary Surgery Hospital, Second Military Medical University, Shanghai, China
Search for more papers by this authorCorresponding Author
Timothy M. Pawlik MD, MPH, PhD, FACS
Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, Ohio
Correspondence Timothy M. Pawlik, MD, MPH, PhD, FACS, FRACS (Hon), Professor and Chair, Department of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, 395W. 12th Ave, Suite 670.
Email: [email protected]
Search for more papers by this authorDrs Lu Wu, Katiuscha Merath, and Ayesha Farooq contributed equally to this study.
Abstract
Background
Systemic chemotherapy is the standard treatment for patients with unresectable extrahepatic cholangiocarcinoma (ECC), however, the survival benefit of chemotherapy is limited. Photodynamic therapy (PDT) has been associated with improved survival among patients with advanced ECC, yet utilization of PDT remains low. We sought to compare the outcomes of patients with unresectable ECC following treatment with PDT versus chemotherapy.
Methods
A review of the National Cancer Database was conducted to identify patients with ECC who were nonsurgically managed between 2004 and 2013. Overall survival (OS) of patients receiving PDT vs systemic chemotherapy was compared using propensity score matching.
Results
After propensity matching (PDT, n = 59; chemotherapy, n = 177), 5-year OS was 17.6% (95% confidence interval [CI], 9.0%-28.6%) among patients who underwent PDT vs 3.8% (95%CI, 0.4%-14.0%) among patients receiving chemotherapy (P < .001). On multivariable analysis PDT was associated with an OS benefit (hazard ratio, 0.72; 95%CI, 0.52-0.998; P = .048). Subset analysis of patients receiving PDT only (n = 45) and patients receiving chemotherapy demonstrated similar results. In subset analysis of patients undergoing PDT-only vs PDT-chemotherapy, OS was comparable.
Conclusion
PDT was associated with a survival benefit compared with chemotherapy alone among patients with unresectable ECC.
Supporting Information
| Filename | Description |
|---|---|
| jso25773-sup-0001-Supplemental_Figure_1.tiff2.2 MB | Supplemental Figure 1. Flowchart of study population (PDT, photodynamic therapy) |
| jso25773-sup-0002-Supplemental_Figure_2.tiff741.7 KB | Supplemental Figure 2. Use of photodynamic therapy versus chemotherapy for non-surgically managed extrahepatic cholangiocarcinoma over time in the unmatched study population from the National Cancer Center Database, 2004-2013 |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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