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Chemosaturation with percutaneous hepatic perfusion (PHP) is a palliative, intra-arterial therapeutic approach that provides a high dose chemotherapy of the liver with reduced systemic exposure. Aim of this retrospective, monocentric study was to analyze PHP as a palliative treatment for unresectable CCA. Toxicity, adverse events and complications were classified using the Common Terminology Criteria for Adverse Events (CTCAE v5.0). Overall response rate (ORR) and disease control rate (DCR) were evaluated according to the Response Evaluation Criteria in Solid Tumors (RECIST1.1). Median overall survival (mOS), median progression-free survival (mPFS) and hepatic mPFS (mhPFS) were computed using Kaplan\u2013Meier estimation. In total 17 patients were treated with 42 PHP between 10\/2014 and 09\/2020. No significant complications occurred during the interventions. mOS was 27.6 (interquartile range (IQR) 16.5\u201337) months from first diagnosis and 9.9 (IQR 3.8\u201321) months from first PHP. mPFS was 4 (IQR 2\u20137) and mhPFS was 4 (IQR 3\u201310) months. ORR was 25% and DCR 75%. Significant, but transient hematotoxicity was frequent with grade 3\/4 thrombopenia after 50%, leukopenia after 26% and anaemia after 21% of the interventions. An increase of transaminases (AST increase after 21% and ALT increase after 14% of the PHP) developed more often than a deterioration of the liver synthesis capacity. Salvage treatment with PHP has the potential to prolong life in selected patients with unresectable, refractory cholangiocarcinoma. The interventional procedure is safe. Post-interventional toxicity is frequent but manageable.<\/jats:p>","DOI":"10.1007\/s10585-022-10193-4","type":"journal-article","created":{"date-parts":[[2022,11,23]],"date-time":"2022-11-23T07:03:12Z","timestamp":1669186992000},"page":"95-104","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["New perspectives in unresectable cholangiocarcinoma? Evaluation of chemosaturation with percutaneous hepatic perfusion as a palliative treatment option"],"prefix":"10.1007","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8805-2291","authenticated-orcid":false,"given":"Cornelia L. 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A. Dewald, Jan B. Hinrichs, Lena S. Becker, Timo C. Meine, Sabine K. Maschke and Anna Saborowski declare no conflicts of interest related to the subject matter of the article. Frank K Wacker declares an institutional scientific grant from Siemens Healthineers, Promedicus Ltd. outside the submitted work and an institutional scientific grant from Delcath Ltd. related to the subject matter of the article. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results. A.V. declares the following speaker, consultancy and advisory roles: Amgen, Roche, Bayer, Sanofi, BMS, Lilly, Novartis, EISAI, AstraZeneca, Merck, Incyte, Ipsen, PierreFabre, MSD, Sirtex, BTG, Servier, Terumo, GSK. The above-mentioned companies had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"All procedures performed in studies involving human participants were in accordance with ethical standards of the institutional and\/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The ethics committee of the Hannover Medical School has reviewed and approved all data management and outcomes related activities of this research project.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent was obtained from all subjects involved in the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}