Long-Term Outcomes of Transarterial Chemoembolization for Intrahepatic Cholangiocarcinoma: Overall Survival and Tumor Response

Purpose This study aims to determine the efficacy of transarterial chemoembolization (TACE) for patients with inoperable intrahepatic cholangiocarcinoma (iCCA) who do not respond to systemic therapy, focusing on overall survival (OS) and tumor response. Methods A total of 339 patients (188 males and 151 females) with a mean age of 59.2 ± 12.8 years were retrospectively evaluated in the study. The OS time was calculated using the Kaplan-Meier method. Tumor response was determined using the Response Evaluation Criteria in Solid Tumors (RECIST). Results The median OS time was 10 months (95% CI: 8.4-11.6) with 6-, 12-, 24-, and 36-month OS rates of 70.5%, 43.9%, 14.3%, and 6.5%, respectively. The evaluation of tumor response according to RECIST was possible in 203 patients. The tumor volume decreased from 240.83 ± 431.80 cm³ to 184.31 ± 316.88 cm³. The rates of stable disease, partial response, complete response, and progressive disease were 84.73% (172/203), 7.88% (16/203), 0.49% (1/203), and 6.9% (14/203), respectively. The local tumor control rate was 93.1% (189/203). Conclusions In case of inoperable and systemic therapy-resistant iCCA, interventional therapy using TACE shows high local tumor control rates among evaluable patients and satisfactory OS for this high-tumor-burden cohort. TACE should be considered as an alternative treatment option and applied in suitable patients. However, these results are limited by the retrospective study design and incomplete RECIST data.