Yttrium90-TARE with or without chemotherapy may improve survival in patients with locally advanced unresectable intrahepatic cholangiocarcinoma

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PURPOSE: The prognosis for patients with unresectable intrahepatic cholangiocarcinoma (iCCA) is poor. This retrospective observational cohort study evaluates survival outcomes in patients with unresectable iCCA after having received one of three different treatment plans offered at a tertiary referral center, chemotherapy alone, chemotherapy plus y90-TARE, or y90-TARE alone, and compares results with the published evidence. PATIENTS AND METHODS: Patients seen at a tertiary center who received one of three treatments (chemotherapy only, chemotherapy plus y90-TARE, or y90-TARE only) were grouped as per their plan. Overall survival, resection rate, and progression free survival were compared. RESULTS: Among the N = 56 patients included CT-only were younger (64 vs. 67.5 vs. 71yrs, p = 0.023) and higher stage III (78% vs. 29% vs. 32%, p = 0.001). More patients in the CT + y90 (36%) and y90-only (37%) groups were downstaged to resection than patients in the CT-only (4%) group; p = 0.014. Median OS for CT-only, CT + y90 and y90 were 13.9, 19.6, and 24.2 months, respectively; p = 0.076. In the adjusted model there was a trend toward improved OS and PFS for patients treated with y90-TARE compared to CT-only; the HR however remained below 1. CONCLUSION: Although not statistically significant in the adjusted model, in univariate analysis patients with unresectable iCCA who received Y90-TARE in their treatment plan experienced better survival outcomes compared to those treated with CT-only.

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