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Open Access Research article

Adjuvant concurrent chemoradiation therapy (CCRT) alone versus CCRT followed by adjuvant chemotherapy: Which is better in patients with radically resected extrahepatic biliary tract cancer?: a non-randomized, single center study

Kyu-Hyoung Lim1, Do-Youn Oh14*, Eui Kyu Chie2, Jin-Young Jang3, Seock-Ah Im14, Tae-You Kim14, Sun-Whe Kim3, Sung Whan Ha2 and Yung-Jue Bang14

Author Affiliations

1 Departments of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea

2 Departments of Radiation Oncology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea

3 Departments of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea

4 Cancer Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea

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BMC Cancer 2009, 9:345  doi:10.1186/1471-2407-9-345

Published: 27 September 2009

Abstract

Background

There is currently no standard adjuvant therapy for patients with curatively resected extrahepatic biliary tract cancer (EHBTC). The aim of this study was to analyze the clinical features and outcomes between patients undergoing adjuvant concurrent chemoradiation therapy (CCRT) alone and those undergoing CCRT followed by adjuvant chemotherapy after curative resection.

Methods

We included 120 patients with EHBTC who underwent radical resection and then received adjuvant CCRT with or without further adjuvant chemotherapy between 2000 and 2006 at Seoul National University Hospital.

Results

Out of 120 patients, 30 received CCRT alone, and 90 received CCRT followed by adjuvant chemotherapy. Baseline characteristics were comparable between the two groups. Three-year disease-free survival (DFS) rates for CCRT alone and CCRT followed by adjuvant chemotherapy were 26.6% and 45.2% (p = 0.04), respectively, and 3-year overall survival (OS) rates were 30.8% and 62.6% (p < 0.01), respectively. CCRT followed by adjuvant chemotherapy showed longer survival than did CCRT alone, especially in R1 resection (microscopically positive margins) or negative lymph node.

Conclusion

Adjuvant CCRT followed by adjuvant chemotherapy prolonged DFS and OS, compared with CCRT alone in patients with curatively resected EHBTC. Adjuvant chemotherapy deserves to consider after adjuvant CCRT. In the future, a randomized prospective study will be needed, with the objective of investigating the role of adjuvant chemotherapy.