Department of Surgery, Division of Clinical Medical Science, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan.
J Hepatobiliary Pancreat Sci. 2012 Jul;19(4):306-13. doi: 10.1007/s00534-011-0498-y.
BACKGROUND/PURPOSE: The aims of this study were to evaluate long-term outcomes and to determine prognostic factors for survival in patients with resected biliary carcinoma who received adjuvant gemcitabine plus S-1 chemotherapy.
Seventy patients with International Union Against Cancer (UICC) stage II, III, or IV biliary carcinoma received postoperative adjuvant chemotherapy consisting of intravenous gemcitabine 700 mg/m(2) on day 1 and oral S-1 60-100 mg/body for seven consecutive days, followed by a 1-week pause of chemotherapy. Patients received up to ten 2-week cycles. Long-term outcomes and predictors of survival with this adjuvant chemotherapy regimen were analyzed.
The median duration of follow-up was 47 months. Fifty-six percent of patients had node-positive disease, and 80% of patients underwent R0 resection. Overall and disease-free survival rates were 91 and 81% at 1 year, 56 and 55% at 3 years, and 40 and 46% at 5 years, respectively. Lymph node status (p = 0.025) and surgical margin status (p = 0.033) were independently associated with long-term survival by multivariate analysis.
Adjuvant gemcitabine plus S-1 chemotherapy may be a promising strategy for patients with resected biliary carcinoma, and nodal status and surgical margin status may be predictors of survival with this treatment strategy.
背景/目的：本研究旨在评估接受吉西他滨联合替吉奥辅助化疗的可切除胆管癌患者的长期预后，并确定其生存的预测因素。
70 例国际抗癌联盟（UICC）分期为 II、III 或 IV 期的胆管癌患者接受术后辅助化疗，方案为静脉注射吉西他滨 700 mg/m²，第 1 天，替吉奥 60-100 mg/体，连续 7 天，然后暂停化疗 1 周。患者接受最多 10 个 2 周周期的治疗。分析该辅助化疗方案的长期疗效和生存预测因素。
中位随访时间为 47 个月。56%的患者有淋巴结阳性疾病，80%的患者行 R0 切除术。1 年时的总生存率和无病生存率分别为 91%和 81%，3 年时分别为 56%和 55%，5 年时分别为 40%和 46%。多因素分析显示，淋巴结状态（p = 0.025）和手术切缘状态（p = 0.033）与长期生存独立相关。
吉西他滨联合替吉奥辅助化疗可能是可切除胆管癌患者的一种有前途的治疗策略，淋巴结状态和手术切缘状态可能是该治疗策略生存的预测因素。
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