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Outcome of Adjuvant Therapy in Biliary Tract Cancers
Outcome of Adjuvant Therapy in Biliary Tract Cancers
- 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.
- Subjects :
- Male
Cancer Research
medicine.medical_specialty
medicine.medical_treatment
Population
Antineoplastic Agents
Hepatic Duct, Common
Adenocarcinoma
Gastroenterology
Disease-Free Survival
Cholangiocarcinoma
Carcinoma, Adenosquamous
Internal medicine
medicine
Adjuvant therapy
Humans
education
Aged
Neoplasm Staging
Proportional Hazards Models
Retrospective Studies
education.field_of_study
Proportional hazards model
business.industry
Hazard ratio
Retrospective cohort study
Chemoradiotherapy, Adjuvant
Middle Aged
Surgery
Radiation therapy
Biliary Tract Surgical Procedures
Bile Ducts, Intrahepatic
Biliary Tract Neoplasms
Bile Duct Neoplasms
Oncology
Chemotherapy, Adjuvant
Female
Gallbladder Neoplasms
Lymph Nodes
business
Chemoradiotherapy
Klatskin Tumor
Subjects
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