A single-center analysis of the survival benefits of adjuvant gemcitabine chemotherapy for biliary tract cancer

Yamanaka, Kenya; Hatano, Etsuro; Kanai, Masashi; Tanaka, Shiro; Yamamoto, Keiichi; Narita, Michiko; Nagata, Hiromitsu; Ishii, Takamichi; Machimoto, Takahumi; Taura, Kojiro; Üemoto, Shinji

doi:10.1007/s10147-013-0578-x

Cited by 36 publications

(33 citation statements)

References 20 publications

(18 reference statements)

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“…We previously reported the significance of fluorine-18 fluorodeoxyglucose positron emission tomography ( 18 FDG-PET) [10] and adjuvant chemotherapy [11] for ICC management. 18 FDG-PET is predictive of lymph node metastasis and ICC recurrence after surgical resection and is useful for identifying patients at high risk for recurrence [10].…”

Section: Introductionmentioning

confidence: 99%

Significant Improvement in Outcomes of Patients with Intrahepatic Cholangiocarcinoma after Surgery

et al. 2016

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Section: Introductionmentioning

confidence: 99%

Significant Improvement in Outcomes of Patients with Intrahepatic Cholangiocarcinoma after Surgery

et al. 2016

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“…9 While these previous studies were valuable in exploring the potential role of adjuvant therapy, most data on the topic of adjuvant therapy for GBC suffer from small, heterogeneous patient populations that mix GBC with extra-and intrahepatic cholangiocarcinoma, as well as include patients who have undergone nononcologic resections. [10][11][12][13] Given this, we sought to evaluate the role of adjuvant CTx and cXRT among patients undergoing curative intent surgical resection for GBC using a large, multicenter, national collaborative database. Specifically, the objective of the current study was to define those factors associated with receipt of adjuvant therapy, as well as evaluate the relative treatment benefit of CTx/cXRT versus surgery alone using propensity-matched analysis of patients undergoing curative intent resection of GBC.…”

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confidence: 99%

Impact of chemotherapy and external beam radiation therapy on outcomes among patients with resected gallbladder cancer: A multi-institutional analysis.

Kim¹,

Amini²,

Wilson³

et al. 2016

JCO

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“…Takada et al demonstrated that patients with GBC receiving adjuvant therapy consisting of mitomycin C and 5-FU after surgery had an improved overall survival (22). Some have recommended adjuvant chemotherapy and chemoradiotherapy after surgery for biliary carcinoma, as shown in Table III (21,24,(33)(34)(35)(36)(37)(38)(39)(40)(41)(42). However, the results of adjuvant external-beam radiation therapy with concurrent 5-FU treatment were unsatisfactory, with a 5-year survival rate of less than 40% (38)(39)(40)(41)(42).…”

Section: Discussionmentioning

confidence: 99%

“…Adjuvant gemcitabine alone was expected to improve the prognosis of patients with GBC after non-curative resections (34). Another study recommended that adjuvant gemcitabine alone might be effective in selected patients with either stage III biliary carcinoma or IHCC (33). Furthermore, adjuvant gemcitabine and S-1 combination chemotherapy has been introduced for its synergistic antitumour effect, and the regimen provided the best clinical impact for patients with UICC stage IIA/B biliary carcinoma, with a 57% survival rate at 5 years after aggressive surgery.…”

Section: Discussionmentioning

confidence: 99%

Effect of Adjuvant Gemcitabine Combined with Low-dose 5-Fluorouracil and Cisplatin Chemotherapy for Advanced Biliary Carcinoma

Morine

Shimada

Ikemoto

et al. 2017

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Abstract. Background Biliary carcinoma, which includes intrahepatic cholangiocarcinoma (IHCC), hilar cholangiocarcinoma (HC) and gallbladder carcinoma (GBC), may be a relatively uncommon malignancy in Western countries, but is one of the most lethal digestive tract tumours because of metastasis or invasion of the tumour directly into adjacent organs at diagnosis. In Japan, the incidence of biliary carcinoma has markedly increased over the past several decades. Vital statistics in 2013 in Japan showed that biliary carcinoma was the sixth leading cause of carcinoma deaths with an incidence of over 22 per 100,000 and a mortality rate of ~15 per 100,000 (1). Complete surgical resection provides the only chance of survival. Many surgeons have advocated aggressive surgery, including major hepatectomy, extended lymph node (LN) dissection and combined vascular resection for improving surgical outcomes (2-8). However, despite aggressive liver surgery, the prognosis after surgery remains unsatisfactory, with 5-year survival rates of 19-35% for HC (5-8), 32-53% for GBC (9-11) and 23-29% for IHCC (12)(13)(14). Moreover, several investigators have indicated that LN metastasis, intrahepatic metastasis and positive surgical margins in the bile duct are poor prognostic factors (12-15). Even with aggressive surgical resection, tumour relapse frequently occurs immediately after surgery, particularly in patients with poor prognostic factors. Nevertheless, no standard treatment before or after surgery has been established, even in patients with biliary carcinoma with high risk factors of recurrence. Therefore, a multidisciplinary strategy including adjuvant therapy is desirable before or after surgery, at least for those patients with poor prognostic factors.For unresectable biliary carcinoma, gemcitabine alone has been regarded as the key antitumour agent (17); recently, gemcitabine combined with cisplatin became the new standard regimen based on the results of the ABC-02 trial (18). In Japan, several investigators have reported the efficacy of gemcitabine plus S-1, an oral anticancer drug consisting of tegafur as a prodrug of 5-fluorouracil (5-FU), 5-chloro-2,4-dihydroxypyridine and potassium oxonate, in advanced biliary carcinoma (18-21). However, adjuvant treatment after surgery has shown little impact on this malignancy, and combinations of effective chemotherapeutic agents and regimens have not been established. With the exception of periampullary carcinoma, only one randomized control trial has demonstrated the efficacy of the combination adjuvant therapy of mitomycin C and 5-FU for 6421

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A single-center analysis of the survival benefits of adjuvant gemcitabine chemotherapy for biliary tract cancer

Abstract: Adjuvant gemcitabine chemotherapy for BTC may be effective, particularly for patients with stage III and ICC.

Cited by 36 publications

References 20 publications

Significant Improvement in Outcomes of Patients with Intrahepatic Cholangiocarcinoma after Surgery

Significant Improvement in Outcomes of Patients with Intrahepatic Cholangiocarcinoma after Surgery

Impact of chemotherapy and external beam radiation therapy on outcomes among patients with resected gallbladder cancer: A multi-institutional analysis.

Effect of Adjuvant Gemcitabine Combined with Low-dose 5-Fluorouracil and Cisplatin Chemotherapy for Advanced Biliary Carcinoma

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