3039 - Patient Reported Quality of Life and Functional Outcomes after Pre-Operative Chemoradiation for Hilar Cholangiocarcinoma

Purpose/Objective(s): Neoadjuvant chemoradiation (CRT) followed by liver transplant for peri-hilar cholangiocarcinoma (P-CCA) is associated with long-term survival in many patients. However, data describing the impact of CRT in health-related quality of life (HRQOL) are limited. We assessed patient reported outcomes (PROs) for HRQOL in patients undergoing CRT prior to liver transplant for P-CCA.

Materials/

Methods: This was a retrospective single-institution cohort study of patients with P-CCA who underwent CRT from 2013-2023 with available PROs. PROs were prospectively collected per the functional assessment of cancer therapy-hepatobiliary questionnaire (FACT-HEP). Change from baseline was assessed at the end of CRT, 3-months post-CRT, and 1-year post-CRT. Minimal clinically important deterioration (MCID) for the total FACT-HEP and hepatobiliary cancer subscale (HCS), defined as a decline of = 6.5 and = 2.1 per prior data, respectively, were used as the proportion meeting MCID thresholds.

Results: 123 patients were included. Median age was 50 years (IQR 41-62). 142 patients (74%) were male. 70% of patients had primary sclerosing cholangitis. Patients received 45 Gy in 30 fractions, twice daily, with concurrent capecitabine or 5-fluoruracil. 102 patients (83%) received a boost using intraluminal brachytherapy. 92% received maintenance chemotherapy after CRT. 87 patients (71%) received a liver transplantation at the time of analysis. Median time from CRT completion to transplant was 135 days (IQR 83-272).

Baseline FACT-HEP scores and changes from baseline are found in the Table. The proportion of patients meeting MCID thresholds of deterioration at the end of CRT, 3-months, and 1-year were 53%, 74%, and 38% for the FACT-Hep total score and were 60%, 76%, and 45% for the HCS.

Conclusion: Patients with P-CCA receiving CRT prior to liver transplantation experience significant acute deterioration in HRQOL. Most recover to baseline by 1 year, although, some have persistent deterioration in HRQOL by 1 year. These data further emphasize the need for symptom surveillance and supportive care measures for this patient cohort.

Abstract 3039 – Table 1