Oral Adjuvant Chemotherapy with S-1 or Uracil-tegafur versus Surgery Alone in Patients with Biliary Tract Cancer

Masatsugu Ishii,Osamu Itano,Naokazu Chiba

doi:10.4172/2167-7700.1000174

Abstract

Abstract Objective: We compared the influence of postoperative adjuvant chemotherapy with oral anticancer drugs (S-1 or uracil-tegafur [UFT]) and the influence of surgery alone on overall survival (OS) and disease-free survival (DFS) in patients with biliary tract cancer. Methods: This retrospective study included 108 patients with gallbladder cancer (n=22) or bile duct cancer (n=86), who underwent curative resection. The patients were divided into surgery alone (n=58), UFT (n=39; 400 mg/m2/day), and S-1 groups (n=11; 80 mg/m2, days 1–28, twice daily), and outcomes and adverse effects were compared. Results: The 2-year DFS rate was significantly higher in the S-1 group than in the surgery alone group for all patients (72.7% vs. 32.8%, p=0.046). For the patients with gallbladder cancer, the 2-year OS and DFS rates were significantly higher in the UFT group than in the surgery alone group (36.4% vs.0%, p=0.033 and 27.4% vs. 0% p=0.032, respectively; log-rank test). For patients with lymph node metastasis, the 2-year OS and DFS rates were significantly higher in the S-1 group than in the surgery alone group (71.4% vs. 18.2%, p=0.039 and 71.4% vs. 18.2%, p=0.026, respectively) Conclusion: Postoperative adjuvant chemotherapy might improve both the OS and DFS rates, particularly in patients with gallbladder cancer and those with biliary tract cancer and lymph node metastasis.

Highlights

Extensive surgical resection of biliary tract cancer is performed in several high-volume centres, even for patients with advanced tumors that were formerly considered unresectable
Previous studies comparing surgical resection combined with postoperative adjuvant chemotherapy and surgical resection alone have demonstrated that adjuvant treatment may be effective for prolonging survival [1]
The 2-year disease-free survival (DFS) rate was significantly higher in the S-1 group than in the surgery alone group

Summary

Introduction

Extensive surgical resection of biliary tract cancer is performed in several high-volume centres, even for patients with advanced tumors that were formerly considered unresectable. The surgical resection rate has increased, satisfactory improvements in survival have not yet been achieved. This indicates the limitations of surgical resection and emphasizes the need for adjuvant treatment. Previous studies comparing surgical resection combined with postoperative adjuvant chemotherapy and surgical resection alone have demonstrated that adjuvant treatment may be effective for prolonging survival [1]. To the best of our knowledge, all previous reports on postoperative adjuvant chemotherapy for biliary tract cancer were pilot studies with a small numbers of patients and a variety of chemotherapy regimens [1,2,3,4,5]

Results

Discussion

Conclusion