Is it safe to administer neoadjuvant chemotherapy to patients undergoing hepatectomy for intrahepatic cholangiocarcinoma? ACS-NSQIP propensity-matched analysis

Woo Jin Choi, Tommy Ivanics, Marco P.A.W. Claasen, Steven Gallinger, Bettina Hansen, Gonzalo Sapisochin*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: The use of neoadjuvant chemotherapy (NAC) in patients with intrahepatic cholangiocarcinoma (iCCA) is increasing. The objective of this study was to compare the 30-day post-operative complications and length-of-stay (LOS) between patients undergoing hepatectomy for iCCA with and without NAC. Methods: A retrospective study was conducted using the ACS-NSQIP database queried from 2014 to 2018. Patients with NAC receipt were propensity-score matched into 1:3 ratio with controls using the greedy-matching algorithm and a caliper of 0.2. Logistic and Poisson regression models were used to estimate the effect sizes. Results: A total of 1508 patients who underwent hepatectomy for iCCA were included. 706 patients remained after matching and balance were achieved. The NAC group had 110 (60.1%) complications vs. 289 (55.3%) complications in the non-NAC group (p = 0.29). NAC was not associated with worse 30-day postoperative complications [OR 1.24, 95% CI: 0.87–1.76; p = 0.24]. Post-operative LOS in the NAC group was 8.56 days (mean, SD 7.4) vs. non-NAC group 9.27 days (mean, SD 8.41, p = 0.32). NAC was not associated with longer post-operative LOS [RR 0.93, 95% CI:0.80, 1.08; p = 0.32]. Conclusion: NAC may be safely administered without increasing the risk of 30-day complications or post-operative hospital LOS.

Original languageEnglish
Pages (from-to)1535-1542
Number of pages8
JournalHPB
Volume24
Issue number9
Early online date30 Mar 2022
DOIs
Publication statusPublished - 1 Sep 2022

Bibliographical note

Funding Information:
None.

Publisher Copyright:
© 2022 International Hepato-Pancreato-Biliary Association Inc.

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