Neither Neoadjuvant nor Adjuvant Therapy Increases Survival After Biliary Tract Cancer Resection with Wide Negative Margins

Evan Glazer, Ping Liu, Eddie K. Abdalla, Jean Nicolas Vauthey, Steven A. Curley

Research output: Contribution to journalArticle

54 Citations (Scopus)

Abstract

Background: We investigated the role of neoadjuvant/adjuvant therapies on survival for resectable biliary tract cancer. We hypothesized that neoadjuvant and adjuvant therapy should improve the survival probability in these patients. Methods: This was a retrospective review of a prospective database of patients resected for gallbladder cancer (GBC) and cholangiocarcinoma (CC). One hundred fifty-seven patients underwent resection for primary GBC (n = 63) and CC (n = 94). Fisher's exact test, Student's t test, the log-rank test, and a Cox proportional hazard model determined significant differences. Results: The 5-year overall survival rate after resection of GBC and CC was 50. 6 % and 30. 4 %, respectively. Of the patients, 17. 8 % received neoadjuvant chemotherapy, 48. 7 % received adjuvant chemotherapy, while 15. 8 % received adjuvant chemoradiotherapy. Patients with negative margins of at least 1 cm had a 5-year survival rate of 52. 4 % (p < 0. 01). Adjuvant therapy did not significantly prolong survival. Neoadjuvant therapy delayed surgical resection on average for 6. 8 months (p < 0. 0001). Immediate resection increased median survival from 42. 3 to 53. 5 months (p = 0. 01). Conclusions: Early surgical resection of biliary tract malignancies with 1 cm tumor-free margins provides the best probability for long-term survival. Currently available neoadjuvant or adjuvant therapy does not improve survival.

Original languageEnglish (US)
Pages (from-to)1666-1671
Number of pages6
JournalJournal of Gastrointestinal Surgery
Volume16
Issue number9
DOIs
StatePublished - Sep 1 2012
Externally publishedYes

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Biliary Tract Neoplasms
Gallbladder Neoplasms
Neoadjuvant Therapy
Survival
Cholangiocarcinoma
Therapeutics
Survival Rate
Adjuvant Chemoradiotherapy
Biliary Tract
Adjuvant Chemotherapy
Proportional Hazards Models
Databases
Students
Drug Therapy

All Science Journal Classification (ASJC) codes

  • Surgery
  • Gastroenterology

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Neither Neoadjuvant nor Adjuvant Therapy Increases Survival After Biliary Tract Cancer Resection with Wide Negative Margins. / Glazer, Evan; Liu, Ping; Abdalla, Eddie K.; Vauthey, Jean Nicolas; Curley, Steven A.

In: Journal of Gastrointestinal Surgery, Vol. 16, No. 9, 01.09.2012, p. 1666-1671.

Research output: Contribution to journalArticle

Glazer, Evan ; Liu, Ping ; Abdalla, Eddie K. ; Vauthey, Jean Nicolas ; Curley, Steven A. / Neither Neoadjuvant nor Adjuvant Therapy Increases Survival After Biliary Tract Cancer Resection with Wide Negative Margins. In: Journal of Gastrointestinal Surgery. 2012 ; Vol. 16, No. 9. pp. 1666-1671.
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abstract = "Background: We investigated the role of neoadjuvant/adjuvant therapies on survival for resectable biliary tract cancer. We hypothesized that neoadjuvant and adjuvant therapy should improve the survival probability in these patients. Methods: This was a retrospective review of a prospective database of patients resected for gallbladder cancer (GBC) and cholangiocarcinoma (CC). One hundred fifty-seven patients underwent resection for primary GBC (n = 63) and CC (n = 94). Fisher's exact test, Student's t test, the log-rank test, and a Cox proportional hazard model determined significant differences. Results: The 5-year overall survival rate after resection of GBC and CC was 50. 6 {\%} and 30. 4 {\%}, respectively. Of the patients, 17. 8 {\%} received neoadjuvant chemotherapy, 48. 7 {\%} received adjuvant chemotherapy, while 15. 8 {\%} received adjuvant chemoradiotherapy. Patients with negative margins of at least 1 cm had a 5-year survival rate of 52. 4 {\%} (p < 0. 01). Adjuvant therapy did not significantly prolong survival. Neoadjuvant therapy delayed surgical resection on average for 6. 8 months (p < 0. 0001). Immediate resection increased median survival from 42. 3 to 53. 5 months (p = 0. 01). Conclusions: Early surgical resection of biliary tract malignancies with 1 cm tumor-free margins provides the best probability for long-term survival. Currently available neoadjuvant or adjuvant therapy does not improve survival.",
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