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Application of Robot-assisted Pancreaticobiliary Junction Resection in Benign Duodenal Tumors

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Adjuvant Therapy for Resectable Biliary Tract Cancer: A Bayesian Network Analysis.

Xiuqiong Chen¹, Fanqiao Meng², Hua Xiong¹

¹Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Frontiers in Oncology

|March 29, 2021

Summary

Gemcitabine (GEM) is the optimal adjuvant therapy for biliary tract cancer (BTC) patients, improving 5-year overall survival (OS). Chemoradiotherapy (CRT) is recommended for patients with positive resection margins or lymph nodes.

Keywords:

adjuvant therapy (AT)biliary tract cancer (BTC)chemo-radiotherapy fluorouracil gemcitabine observation radiotherapy

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Area of Science:

Oncology
Surgical Oncology
Medical Oncology

Background:

Adjuvant therapy selection is critical for improving overall survival (OS) in biliary tract cancer (BTC) patients.
Postoperative recurrence and metastasis significantly impact OS in BTC.
Identifying optimal adjuvant treatment strategies is essential for enhancing patient outcomes.

Approach:

A comprehensive literature search was conducted across major databases (PubMed, Web of Science, Embase) for studies on BTC therapy.
Hazard ratios (HR) and 95% confidence intervals (CIs) were used to evaluate the efficacy of various adjuvant therapy regimens.
Statistical analyses were performed using GemTc and R software to synthesize data from 22 articles involving 14,646 patients.

Key Points:

Gemcitabine (GEM) demonstrated superior 5-year OS compared to chemoradiotherapy (CRT), observation (OB), and radiotherapy (RT).
5-fluorouracil (5-FU) showed improved efficacy over RT and OB, and was more effective than GEM.
Chemoradiotherapy (CRT) and radiotherapy (RT) significantly improved OS for patients with positive resection margins (R+) and positive lymph nodes (N+).

Conclusions:

Gemcitabine (GEM) is suggested as a first-line adjuvant therapy for resected biliary tract cancer (BTC) patients.
Chemoradiotherapy (CRT) emerges as the optimal treatment for BTC patients with positive resection margins (R+) and positive lymph nodes (N+).
Further research may explore combination therapies to further improve recurrence-free survival and 1-year OS.