To evaluate the effect of postoperative adjuvant chemotherapy on clinical prognosis of patients with hilar cholangiocarcinoma after surgical resection.

Clinical data of 86 patients with hilar cholangiocarcinoma who underwent surgical resection in Sun Yat-sen Memorial Hospital of Sun Yat-sen University from January 2012 to December 2017 were retrospectively analyzed. Among them, 52 patients were male and 34 female, aged from 28 to 79 years, with a median age of 60 years. The informed consents of all patients were obtained and the local ethical committee approval was received. According to whether receiving postoperative adjuvant chemotherapy, the patients were divided into the adjuvant chemotherapy group (n=42) and operation group (n=44). After 1:1 ratio propensity score matching (PSM), the influencing factors for the survival and prognosis were analyzed. Survival analysis was conducted by Kaplan-Meier method and Log-rank test. Prognostic factors were identified by Cox proportional hazard regression model.

After PSM, the median survival of patients was 22 months in the adjuvant chemotherapy group and 9 months in the operation group. In the adjuvant chemotherapy group, the 1-, 2-year cumulative survival rates were 78.6%, 42.9%, and 46.4%, 14.3% in the operation group. The overall survival in the adjuvant chemotherapy group was significantly better than that in the operation group (χ²=10.800, P<0.05). In the adjuvant chemotherapy, the median survival of patients with positive lymph node was 19 months, and the overall survival was significantly better than that in the operation group (χ²=5.824, P<0.05). Cox multivariate analysis showed that lymph node metastasis and postoperative adjuvant chemotherapy were the independent prognostic factors of patients with hilar cholangiocarcinoma after surgical resection (HR=1.903, 0.343; P<0.05).

Postoperative adjuvant chemotherapy can improve the clinical prognosis of patients with hilar cholangiocarcinoma after surgical resection, especially those with lymph node metastasis.