Morino Koshiro, Seo Satoru, Yoh Tomoaki, Nishino Hiroto, Yamanaka Kenya, Fukumitsu Ken, Ishii Takamichi, Taura Kojiro, Okajima Hideaki, Kaido Toshimi, Uemoto Shinji
Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
Anticancer Res. 2019 Apr;39(4):2155-2161. doi: 10.21873/anticanres.13329.
BACKGROUND/AIM: The impact of adjuvant chemotherapy (AC) for extrahepatic cholangiocarcinoma (ECC) remains unclear. This study evaluated the efficacy and limitations of AC.
Between 2006 and 2016, 106 patients with stage II-IV ECC who underwent curative resection with biliary tract reconstruction were retrospectively analyzed. Patients were divided into two groups: Those who received AC (n=57) and those who did not (n=49).
Fewer grade 3-4 complications were observed in the AC group compared to the non-AC group (38.6 vs. 61.2%, p=0.03). In the non-AC group, complications were the most frequent reason for omitting AC (n=21, including 13 with biliary fistula). In the AC group, the therapy completion rate was 56.1% and the main reason for discontinuation was adverse events (n=12, including six with cholangitis). AC was not associated with survival benefits (median survival: 50.4 vs. 37.3 months, p=0.916).
AC for ECC might be inadequate as a standard strategy due to the low implementation and completion rates because complications often hamper administration.
背景/目的：辅助化疗（AC）对肝外胆管癌（ECC）的影响尚不清楚。本研究评估了AC的疗效和局限性。
回顾性分析2006年至2016年间106例行根治性切除并胆道重建的II-IV期ECC患者。患者分为两组：接受AC的患者（n = 57）和未接受AC的患者（n = 49）。
与非AC组相比，AC组观察到的3-4级并发症更少（38.6%对61.2%，p = 0.03）。在非AC组中，并发症是省略AC的最常见原因（n = 21，包括13例胆瘘）。在AC组中，治疗完成率为56.1%，停药的主要原因是不良事件（n = 12，包括6例胆管炎）。AC与生存获益无关（中位生存期：50.4对37.3个月，p = 0.916）。
由于并发症常常妨碍给药，导致AC的实施率和完成率较低，因此AC作为ECC的标准策略可能并不充分。
