Abstract Objective The benefit of adjuvant chemotherapy for resected biliary tract carcinoma (BTC) is unclear; however, the JCOG1202 trial indicated that S-1 may be effective. This retrospective study evaluated the effectiveness of S-1 adjuvant chemotherapy for resected BTC at a single institute. Methods Seventy-five patients who underwent resection for BTC between 2014 and 2021 were classified as surgery alone (N=29) or surgery plus S-1 (N=46). Outcomes, including relapse-free survival (RFS) and overall survival (OS), were compared between the groups. Results The cohort (mean age, 72.2 years) included 51 men and 24 women. No differences in patient characteristics (age, sex, tumor-node-metastasis classification, Union for International Cancer Control stage, and residual tumor (R) classification) were observed between the groups. Grade 3/4 adverse events were not observed, and relative dose intensity was 84.8%. No differences were observed between the groups regarding RFS and OS, nor in RFS when excluding those with R2 (p=0.599). However, a significant difference was observed in OS between the groups in the latter case (p=0.04), with median survival times of 22.2 months for surgery alone and 64.5 months for surgery plus S-1. Conclusion S-1 adjuvant chemotherapy prolonged OS in patients with BTC treated by curative resection (excluding R2).
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