Antineoplastic Agents/administration & dosage ; Antineoplastic Agents/therapeutic use* ; Bile Duct Neoplasms/drug therapy* ; Bile Duct Neoplasms/pathology ; Bile Duct Neoplasms/surgery ; Bile Ducts, Extrahepatic/pathology ; Bile Ducts, Extrahepatic/surgery* ; CA-19-9 Antigen/blood ; Chemotherapy, Adjuvant/methods ; Female ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Grading ; Prognosis ; Retrospective Studies ; Survival Rate
Keywords
Prognostic factor ; Extrahepatic bile duct cancer ; Overall survival ; Adjuvant chemotherapy
Abstract
BACKGROUND: Surgical resection is the only curative treatment for extrahepatic bile duct cancer. Additionally, the recurrence rate after curative surgery is relatively high, requiring adjuvant therapy. However, the efficacy of adjuvant chemotherapy compared with surgery alone has not yet been clarified. This study aimed to evaluate the efficacy of adjuvant chemotherapy and identify prognostic factors influencing survival in extrahepatic bile duct cancer patients who underwent curative surgical resection.
METHODS: Ninety-seven patients with extrahepatic bile duct cancer who underwent curative resection between January 2005 and December 2010 were retrospectively analyzed.
RESULTS: Among the 97 patients, 31 underwent adjuvant chemotherapy and 66 did not. The 5-year overall survival rate was 34% for patients who underwent adjuvant chemotherapy. There was no significant difference for overall survival between patients who underwent adjuvant chemotherapy and those who did not (p = 0.228). On multivariate analysis, postoperative carbohydrate antigen 19-9 levels and histologic grade were independent prognostic factors related to long-term survival (p < 0.05).
CONCLUSIONS: Postoperative adjuvant chemotherapy did not improve survival after surgical resection for extrahepatic bile duct cancer.