Post-study treatment
tumor, neutropenia, intrahepatic cholangiocarcinoma, toxicity, gastrointestinal bleeding, infection
DISEASE PROGRESSION, TUMOR, NEUTROPENIA, GASTROINTESTINAL BLEEDING, INFECTION, INTRAHEPATIC CHOLANGIOCARCINOMA, SEVERE ACUTE RESPIRATORY SYNDROME
At the time of final follow-up, all patients had discontinued the planned treatment of FOLFIRINOX because of disease progression in 26 (74.3%), unacceptable toxicity in 4 (11.4%; prolonged neutropenia in 2, continuous gastrointestinal bleeding in 1, severe acute respiratory syndrome coronavirus-2 infection in 1), withdrawal of consent in 2 (5.7%), or conversion surgery with curative intent after remarkable tumor shrinkage in 3 (8.6%). Twenty-five patients (71.4%) received second-line chemotherapy (GC in 18, GCS in 4, GC combined with fluorouracil in 2 and S-1 in 1), and 14 patients (40.0%) received third-line chemotherapy (S-1 in 7, GC or gemcitabine in 2 each, GS or clinical trial in 1 each). In total, four patients were converted to be surgical candidates after chemotherapy and they subsequently underwent surgery, resulting in R0 resection in 3. Notably, the surgical specimen revealed a pathologic complete response in one patient with initially metastatic intrahepatic cholangiocarcinoma.