Original Study: Risk Factors for Early Recurrence in Patients With Biliary Tract Cancers Who Underwent Curative...

Area of Science:

• Oncology
• Surgical Oncology
• Gastroenterology

Background:

• Early recurrence (ER) of biliary tract cancers (BTCs) post-surgery poses significant challenges.
• Approximately 30% of patients with curatively resected BTCs experience recurrence within 12 months.
• Adjuvant S-1 chemotherapy has demonstrated a survival benefit in resected BTCs.

Purpose of the Study:

• To investigate risk factors for early recurrence (ER) in patients with resected BTCs.
• To analyze data from the JCOG1202 randomized phase III trial cohort.
• To identify factors influencing ER for improved patient management.

Main Methods:

• Analysis of 424 patients from the JCOG1202 trial (217 observation, 207 adjuvant S-1).
• ER defined as recurrence or death within 12 months post-enrollment.
• Multivariable logistic regression used to identify independent risk factors.

Main Results:

• Elevated CA19-9 levels (>37 U/ml), poor/moderate differentiation, ≥4 or 1-3 lymph node metastases, and R1 resection were significant risk factors for ER.
• Adjuvant S-1 chemotherapy significantly reduced the risk of ER (OR: 0.49).
• ER was observed in 59 patients in the observation group and 38 in the S-1 group.

Conclusions:

• Postoperative CA19-9 levels, tumor differentiation, lymph node status, and residual tumor are key predictors of ER in resected BTCs.
• Adjuvant S-1 chemotherapy is effective in reducing ER.
• Patients identified as high-risk for ER may benefit from more intensive adjuvant therapy.