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Outcome of Adjuvant Therapy in Biliary Tract Cancers

Outcome of Adjuvant Therapy in Biliary Tract Cancers

Authors :
Sean P. Cleary
Laura A. Dawson
David W. Hedley
Trisha Min
Malcolm A.S. Moore
Monika K. Krzyzanowska
Stefano Serra
Paul D. Greig
Elizabeth McKeever
Steven Gallinger
Anne M. Horgan
Elaine Wallace
Mairéad G McNamara
Eitan Amir
Jennifer J. Knox
Thomas Walter
Source :
American Journal of Clinical Oncology. 38:382-387
Publication Year :
2015
Publisher :
Ovid Technologies (Wolters Kluwer Health), 2015.

Abstract

OBJECTIVE:: There are high rates of recurrence after definitive surgery in biliary tract cancer patients. We reviewed the use and effectiveness of adjuvant therapy (AT; chemotherapy�radiotherapy) in a single institution series. METHODS:: Characteristics, treatment details, and follow-up data of all patients with biliary tract cancer who had definitive surgery from January 1987 to September 2011 were reviewed. The association between baseline variables and disease-free survival/overall survival (OS) were tested using Cox proportional hazard analysis in the univariable and multivariable settings. RESULTS:: Analysis included 296 patients (58% male; median age, 63 y). Negative or microscopically positive resections were reported in 42% and 14%, respectively, with 44% not reported. Node positivity was reported in 35% patients. AT was given in 28% of patients with 59% receiving chemotherapy and 35% concurrent chemotherapy/radiotherapy. Disease recurred in 60% patients. AT was associated with significantly improved OS (hazard ratio, 0.41; P=0.02). Compared with R0 resection, patients with R1 resection derived significantly increased benefit from AT (P for difference 0.02). In the node positive population (n=103), AT was associated with significantly improved OS (hazard ratio, 0.60; 95% confidence interval, 0.38-0.95; P=0.03). CONCLUSIONS:: Patients with R1 resection and node positive disease receiving AT after definitive surgery seem to derive OS advantage. Large prospective trials are needed to confirm these data.

Details

ISSN :
02773732
Volume :
38
Database :
OpenAIRE
Journal :
American Journal of Clinical Oncology
Accession number :
edsair.doi.dedup.....c93db052b21f057396c179ddd63d516a
Full Text :
https://doi.org/10.1097/coc.0b013e31829e19fb