Miyata Yoichi, Kogure Ryota, Nakazawa Akiko, Nagata Rihito, Mitsui Tetsuya, Ninomiya Riki, Komagome Masahiko, Maki Akira, Kawarabayashi Nobuaki, Beck Yoshifumi
Department of Surgery, Asahi General Hospital, 1326 I, Asahi-shi, Chiba 289-2511, Japan.
Department of Surgery, National Defence Medical College, 3-2 Namiki, Tokorozawa-shi, Saitama 359-8513, Japan.
J Clin Med. 2021 Mar 1;10(5):925. doi: 10.3390/jcm10050925.
Even though S-1 is a widely used chemotherapeutic agent, there is no evidence for its use in an adjuvant setting for biliary tract carcinoma (BTC). Patients who underwent surgical treatment for BTC between August 2007 and December 2018 were selected. Propensity score matching was performed between patients who received S-1 as adjuvant chemotherapy (S-1 group) and those who underwent surgical treatment alone (observation group). Of 170 eligible patients, 38 patients were selected in each group after propensity score matching. Among those in the matched cohort, both the median recurrence-free survival (RFS) and overall survival (OS) in the S-1 group were significantly longer than those in the observation group (RFS, 61.2 vs. 13.1 months, = 0.033; OS, not available vs. 28.2 months, = 0.003). A multivariate analysis of the OS revealed that perineural invasion and adjuvant S-1 chemotherapy were independent prognostic factors. According to a subgroup analysis of the OS, the S-1 group showed significantly better prognoses than the observation group among patients with perineural invasion ( < 0.001). S-1 adjuvant chemotherapy might improve the prognosis of BTC, especially in patients with perineural invasion.
尽管S-1是一种广泛使用的化疗药物，但尚无证据表明其可用于胆道癌（BTC）的辅助治疗。选取2007年8月至2018年12月期间接受BTC手术治疗的患者。对接受S-1辅助化疗的患者（S-1组）和仅接受手术治疗的患者（观察组）进行倾向评分匹配。在170例符合条件的患者中，倾向评分匹配后每组选取38例患者。在匹配队列中，S-1组的无复发生存期（RFS）和总生存期（OS）的中位数均显著长于观察组（RFS，61.2个月对13.1个月，P = 0.033；OS，不可用对28.2个月，P = 0.003）。对OS进行多因素分析显示，神经周围侵犯和辅助S-1化疗是独立的预后因素。根据OS的亚组分析，在有神经周围侵犯的患者中，S-1组的预后明显优于观察组（P < 0.001）。S-1辅助化疗可能改善BTC的预后，尤其是在有神经周围侵犯的患者中。
