Adjuvant chemotherapy in resectable cholangiocarcinoma patients

Abstract

AC significantly prolongs survival time in resectable cholangiocarcinoma patients, particularly in the high risk group.

Efficacy of Adjuvant Chemotherapy and Prognostic Factors for Patients with Extrahepatic Bile Duct Cancer

“…In previous studies, the prognostic factors for extrahepatic bile duct cancer after surgical resection have been reported to be the depth of invasion, pancreatic invasion, duodenal invasion, perineural invasion, lymph node metastasis, the resection margin status and the TNM stage [8,14,17,18,19,20]. In the present study, multivariate analysis showed that the histologic grade and the postoperative CA 19-9 level were independent prognostic factors for OS.…”

The efficacy of fluoropyrimidine-based adjuvant chemotherapy on biliary tract cancer after R0 resection

“…Previous studies reported that adjuvant therapy was beneficial to BTC patients with R1 or R2 resection [4, 9, 15, 19]. Takada et al [9] reported that the 5-year survival rate in patients with stages II–IV gallbladder cancer was significantly higher in the adjuvant chemotherapy group treated with mitomycin C and 5-FU than in the surgery alone group.…”

“…In the subgroup analysis, the benefit of adjuvant chemotherapy to gallbladder cancer was observed only in patients with non-curative resection, not in those with R0 resection [9]. Another recent study showed the benefits of adjuvant chemotherapy in high-risk BTC patients with high CA 19-9 level, advanced disease, lymph node involvement, and R1 resection, but not in those with R0 resection [15]. Moreover, the two studies did not stratify patients with R0 resection by specific prognostic factors; thus, it was difficult to conclude who would benefit from adjuvant chemotherapy.…”

“…Current information on the efficacy of adjuvant chemotherapy on BTC mostly comes from single-arm or retrospective studies. Several studies compared the efficacy of adjuvant chemotherapy with that of surgery alone; however, these studies included heterogeneous patient populations in terms of tumor location, stage, and margin status, and the conflicting results made it difficult for physicians to know who will benefit from adjuvant chemotherapy [9–15]. Some studies showed that patients with high-risk diseases, such as microscopically margin-positive (R1) resection disease, lymph node-positive disease, and advanced-stage disease, were likely to benefit from adjuvant chemotherapy [14, 15].…”

“…Several studies compared the efficacy of adjuvant chemotherapy with that of surgery alone; however, these studies included heterogeneous patient populations in terms of tumor location, stage, and margin status, and the conflicting results made it difficult for physicians to know who will benefit from adjuvant chemotherapy [9–15]. Some studies showed that patients with high-risk diseases, such as microscopically margin-positive (R1) resection disease, lymph node-positive disease, and advanced-stage disease, were likely to benefit from adjuvant chemotherapy [14, 15]. A meta-analysis, which included 20 studies with 6712 patients, showed that patients with BTC benefited more from adjuvant chemotherapy or chemoradiotherapy than from radiotherapy alone, and that the greatest benefit from adjuvant therapy was observed in patients who underwent R1 resection and/or had lymph node-positive disease [4].…”