Abstract
367 Background: Prognosis of patients with advanced biliary carcinoma is still poor, and chemotherapy has been shown to have little impact. The aim of the present study was to clarify the effectiveness of GEM combined with CDDP and 5FU (GFP) therapy for advanced biliary carcinoma. The usefulness as a postoperative adjuvant chemotherapy using GFP (UMIN000006924) was evaluated. Methods: 1. Identification of independent poor prognostic factors: One hundred one patients with biliary carcinoma before induction of GFP chemotherapy, including intrahepatic cholangiocarcinoma (IHC: n=33), hilar cholangiocarcinoma (HC: n=29), and gallbladder cancer (GBC: n=39) were enrolled. The prognostic factors were investigated by multivariate analysis using Cox’s proportional hazard model. 2. Clinical usefulness of adjuvant GFP chemotherapy: One hundred forty-eight patients with biliary carcinoma (IHC: n=46, HC: n=43, GBC: n=39), who were positive for poor prognostic factors, received postoperative adjuvant GFP chemotherapy. The prognosis of these patients was compared to those not having postoperative adjuvant chemotherapy. Results: 1. In multivariate analysis, non-curative resection, lymph nodes metastasis and intrahepatic metastasis were identified as the independent prognostic factors. 2. Seventy-nine patients (53.3%) had poor prognostic factors. Of these, 22 patients received postoperative adjuvant GFP chemotherapy. The prognosis of patients with poor prognostic factors, who received postoperative adjuvant GFP chemotherapy, was significantly better than those not having such adjuvant chemotherapy (p<0.01) (3y survival: 59.6% vs. 18.9%). Furthermore, in patients with non-curative resection, postoperative adjuvant GFP chemotherapy also prolonged postoperative prognosis (p<0.01) (3y survival: 62.5% vs. 9.4%) Conclusions: Postoperative GFP adjuvant chemotherapy for patients with poor prognostic factors may improve the surgical outcomes.
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