Benefiting Subgroup From Adjuvant Chemotherapy in Intrahepatic Cholangiocarcinoma: A Propensity Score‐Matched Study
7 affiliations
- 1Department of Hepatobiliary and Pancreatic Surgery The First Affiliated Hospital, Zhejiang University School of Medicine Hangzhou China
- 2Department of Hepatobiliary and Pancreatic Surgery Ningbo Medical Center Lihuili Hospital (The Affiliated Lihuili Hospital, Ningbo University) Ningbo China
- 3Emergency Trauma Center The First Affiliated Hospital, Zhejiang University School of Medicine Hangzhou China
- 4Department of Hepatobiliary and Pancreatic Surgery Shangyu People's Hospital of Shaoxing, Shaoxing University Shaoxing China
- 5Zhejiang Provincial Key Laboratory of Pancreatic Disease Hangzhou China
- 6Zhejiang Provincial Clinical Research Center for the Study of Hepatobiliary and Pancreatic Diseases Hangzhou China
- 7Cancer Center Zhejiang University Hangzhou China
Abstract
The survival benefit of adjuvant chemotherapy (ACT) following resection of intrahepatic cholangiocarcinoma (iCCA) remains controversial; moreover, the patient group that could benefit most from this approach remains undetermined. We conducted a retrospective cohort study of 423 patients (median age 65 years; 52.2% male; 297 patients who received ACT) who underwent curative intent resection of iCCA between 2021 and 2024. To minimize selection bias, propensity score matching (PSM) at a 2:1 ratio was performed. Overall survival (OS) was the primary end point. Survival analyses were conducted using Kaplan–Meier and Cox regression methods. In the PSM‐matched cohort, ACT significantly improved OS compared to observation alone (hazard ratio [HR] = 0.52, 95% confidence interval [CI]: 0.32–0.82, p = 0.005). Subgroup analyses revealed marked heterogeneity in treatment effect. The most remarkable finding was a strong interaction between treatment and histological subtype (p for interaction = 0.041). Patients with small‐duct type iCCA derived a substantial survival benefit from ACT (HR = 0.33, 95% CI: 0.17–0.63, p = 0.001). In contrast, patients with large‐duct type iCCA did not show a significant OS benefit (HR = 0.89, 95% CI: 0.45–1.76, p = 0.737). In conclusion, postoperative ACT was associated with improved OS after resection of iCCA. Exploratory interaction analyses suggested that the magnitude of this association may differ according to histological subtype, with a more pronounced survival benefit observed in patients with small‐duct type iCCA. These findings should be considered hypothesis‐generating and require confirmation in independent prospective cohorts before histological subtype can be incorporated into treatment‐selection strategies.
Related
- Hepatic arterial infusion chemotherapy in combination with immune checkpoint inhibitors and targeted therapy for advanced intrahepatic cholangiocarcinoma.
- Inhibition of the ZEB1–BCL2 axis in cancer-associated fibroblasts as a strategy to improve chemotherapy response in intrahepatic cholangiocarcinoma
- Number of examined lymph nodes and overall survival in intrahepatic cholangiocarcinoma: a population-based study suggesting a staging benefit
- OLFM4 promotes intrahepatic cholangiocarcinoma progression through a PKM2-glycolysis-histone lactylation feedback loop.
- Same organ, divergent immunity: T-cell exhaustion versus stromal exclusion in hepatocellular carcinoma and intrahepatic cholangiocarcinoma
BibTeX
@article{lu2026benefiting,
title = {{Benefiting Subgroup From Adjuvant Chemotherapy in Intrahepatic Cholangiocarcinoma: A Propensity Score‐Matched Study}},
author = {Yeting Lu and Xinsuo Zhuang and Huan Luo and Fan Gao and Jiaqi Yang and Yiwen Chen and Yan Shen and Min Zhang and Jian Wu and Shunliang Gao and Jun Yu and Risheng Que and Xueli Bai},
journal = {Cancer Medicine},
year = {2026},
month = nov,
doi = {10.1002/cam4.72476},
url = {https://doi.org/10.1002/cam4.72476},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Benefiting Subgroup From Adjuvant Chemotherapy in Intrahepatic Cholangiocarcinoma: A Propensity Score‐Matched Study
AU - Yeting Lu
AU - Xinsuo Zhuang
AU - Huan Luo
AU - Fan Gao
AU - Jiaqi Yang
AU - Yiwen Chen
AU - Yan Shen
AU - Min Zhang
AU - Jian Wu
AU - Shunliang Gao
AU - Jun Yu
AU - Risheng Que
AU - Xueli Bai
PY - 2026
DA - 2026/11/05
JO - Cancer Medicine
DO - 10.1002/cam4.72476
UR - https://doi.org/10.1002/cam4.72476
AB - The survival benefit of adjuvant chemotherapy (ACT) following resection of intrahepatic cholangiocarcinoma (iCCA) remains controversial; moreover, the patient group that could benefit most from this approach remains undetermined. We conducted a retrospective cohort study of 423 patients (median age 65 years; 52.2% male; 297 patients who received ACT) who underwent curative intent resection of iCCA between 2021 and 2024. To minimize selection bias, propensity score matching (PSM) at a 2:1 ratio was performed. Overall survival (OS) was the primary end point. Survival analyses were conducted using Kaplan–Meier and Cox regression methods. In the PSM‐matched cohort, ACT significantly improved OS compared to observation alone (hazard ratio [HR] = 0.52, 95% confidence interval [CI]: 0.32–0.82, p = 0.005). Subgroup analyses revealed marked heterogeneity in treatment effect. The most remarkable finding was a strong interaction between treatment and histological subtype (p for interaction = 0.041). Patients with small‐duct type iCCA derived a substantial survival benefit from ACT (HR = 0.33, 95% CI: 0.17–0.63, p = 0.001). In contrast, patients with large‐duct type iCCA did not show a significant OS benefit (HR = 0.89, 95% CI: 0.45–1.76, p = 0.737). In conclusion, postoperative ACT was associated with improved OS after resection of iCCA. Exploratory interaction analyses suggested that the magnitude of this association may differ according to histological subtype, with a more pronounced survival benefit observed in patients with small‐duct type iCCA. These findings should be considered hypothesis‐generating and require confirmation in independent prospective cohorts before histological subtype can be incorporated into treatment‐selection strategies.
SN - 2045-7634
ER -