Adjuvant treatment in biliary tract cancer.

Biliary tract cancers (BTCs) are a heterogeneous group of malignancies with a dismal prognosis. Despite radical surgery, the five-year overall survival (OS) does not exceed 40% in the best series. Adjuvant treatments are widely used even though they have mainly been investigated in small retrospective series until recently. Available data suggest that chemotherapy with 5-fluorouracil (and relative prodrugs) or gemcitabine can reduce the risk of relapse and potentially improve patients' long-term outcome. The role of adjuvant radiotherapy seems to be confined to patients with positive surgical margins. In addition, patients with high-risk factors for relapse (nodal involvement and non-radical resection) benefit most from chemotherapy. Recent results from large randomized trials have clarified the benefit of adjuvant treatments and probably defined a new standard of care.
Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/tcr.2018.08.17). The series “Primary Liver Cancer” was commissioned by the editorial office without any funding or sponsorship. GB served as the unpaid Guest Editor of the series and serves as the unpaid editorial board member of Translational Cancer Research from Jan 2019 to Dec 2020. The authors have no other conflicts of interest to declare.
(2019 Translational Cancer Research. All rights reserved.)