The addition of TACE to palliative chemotherapy is associated with extended survival in unresectable intrahepatic cholangiocarcinoma

Introduction Intrahepatic cholangiocarcinoma (iCCA) represents the second most common primary liver cancer. Both incidence and mortality of iCCA have been increasing over the last decades. Aggressive tumor biology and lack of early symptoms account for dismal prognosis. Recent studies suggest that multimodal treatment strategies combining palliative chemotherapy (pCTX) with locoregional therapies improve overall survival (OS).

Objective This study aimed to assess the OS of patients treated with transarterial chemoembolization (TACE) and pCTX in unresectable iCCA at our tertiary care center.

Methods Between January 2010 and December 2020, 73 patients with unresectable iCCA met the inclusion criteria for this retrospective study. While a total of 14 patients received both pCTX and TACE, the non-randomized control group of 59 patients was treated with pCTX alone.

Results Both groups were treated with a median of two pCTX lines. Patients in the pCTX+TACE group received a median number of 3.5 TACE sessions. The pCTX+TACE group showed a median OS benefit of 13.1 months from the time of unresectability (median OS 26.2 months vs. 13.1 months in the pCTX group, p = 0.008). Controlling for albumin, bilirubin, ECOG performance status and UICC stage, the additional treatment with TACE still conferred an OS benefit of 12.95 months (p = 0.014). A propensity score matching analysis resulted in an OS benefit of 14 months from the time of unresectability for the pCTX+TACE group (p = 0.020).

Conclusion The addition of TACE to pCTX seems to confer an OS benefit for patients with unresectable iCCA. Thus, patients with advanced-stage iCCA receiving standard-of-care pCTX should be considered for additional treatment with TACE.

Publication History

Article published online:
07 September 2021