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

Abstract

BackgroundThe optimal treatment strategy for biliary tract cancer (BTC) after curative-intent resection remains controversial. The purpose of this study was to evaluate the efficacy of fluoropyrimidine-based adjuvant chemotherapy for BTC patients undergoing microscopically margin-negative (R0) resection.MethodsWe retrospectively analyzed the clinical data of BTC patients who underwent curative-intent R0 resection. Patients were eligible if they received either fluoropyrimidine-based adjuvant chemotherapy or observation after R0 resection.ResultsA total of 153 patients were included. In the entire patient cohort, no significant differences were observed in 5-year overall survival (OS) rates (48.4% vs. 39.6%, P = 0.439) or 3-year recurrence-free survival (RFS) rates (49.1% vs. 39.5%, P = 0.299) between patients who received fluoropyrimidine-based adjuvant chemotherapy or observation. However, for patients with stages II and III BTC, chemotherapy significantly improved 5-year OS rate (52.4% vs. 35.6%, P = 0.002) and 3-year RFS rate (55.5% vs. 39.1%, P = 0.021) compared with observation.ConclusionFluoropyrimidine-based adjuvant chemotherapy may prolong the survival of patients with stages II and III BTC after R0 resection.

Randomized clinical trial of adjuvant gemcitabine chemotherapy versus observation in resected bile duct cancer

“…Several retrospective studies have evaluated the effect of adjuvant chemotherapy in resected biliary tract cancer. These reports have many flaws, including heterogeneous disease, limited numbers of patients, long study period and a variety of regimens.…”

The Efficacy of S-1 as Adjuvant Chemotherapy for Resected Biliary Tract Carcinoma: A Propensity Score-Matching Analysis

“…Several studies have reported on adjuvant chemotherapy for BTC [ 10 , 11 , 15 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 ]. The multicentre randomized phase III trial PRODIGE 12-ACCORD 18 conducted by a French group failed to show the efficacy of gemcitabine and oxaliplatin (GEMOX) in treating BTC patients in an adjuvant setting [ 10 ].…”

“…Regarding BTC, some studies showed that adjuvant S-1 improved the prognosis [ 14 , 15 ]. Given that S-1 contains the 5-fluorouracil (5-FU) prodrug tegafur [ 13 ], previous studies using 5-FU as adjuvant chemotherapy for BTC [ 21 , 23 ] have also suggested the potential efficacy of S-1. Recently, a multicentre randomized phase III trial of adjuvant chemotherapy for BTC (BILCAP) reported the efficacy of capecitabine, one of the prodrugs of 5-FU, with an OS of 53 months in the adjuvant group versus 36 months in the observation group ( p = 0.028) [ 24 ].…”

The efficiency and regimen choice of adjuvant chemotherapy in biliary tract cancer

“…However, for patients with stages II and III BTC, chemotherapy significantly improved 5-year OS rate (52.4% vs 35.6%, P = .002) and 3-year RFS rate (55.5% vs 39.1%, P = .021) compared with observation. [15]…”