BACKGROUND Biliary tract cancers (BTC) have a poor prognosis even after curative resection because of frequent local and distant recurrences. Therefore, the importance of adjuvant therapy in BTC has been advocated to improve outcomes. However, the choice of adjuvant therapy is still controversial. The aim of this study was to compare the effects of adjuvant concurrent chemoradiotherapy (CCRT) and chemotherapy on resected BTC. METHODS We analyzed 92 patients who had curatively resected BTC and had received adjuvant CCRT or chemotherapy from January 2000 to December 2017 at Keimyung University Dongsan Medical Center. RESULTS Of the patients, 46 received adjuvant CCRT and 46 received adjuvant chemotherapy. The median recurrence-free survival (RFS) for the adjuvant CCRT and chemotherapy groups were 13.8 and 11.2 months (p = 0.014), respectively. The median overall survival (OS) for the adjuvant CCRT and chemotherapy groups were 30.1 and 26.0 months (p = 0.222), respectively. Adjuvant CCRT had significantly better RFS and numerically higher OS than did chemotherapy. For subgroups with no lymph node (LN) involvement (RFS p = 0.006, OS p = 0.420) or negative resection margins (RFS p = 0.042, OS p = 0.098), adjuvant CCRT led to significantly longer RFS and numerically higher OS than did chemotherapy. For multivariate analysis, the pattern of adjuvant treatment (chemotherapy vs. CCRT, p = 0.004, HR 2.351), histologic grade (poor vs. well, p = 0.023, HR 4.793), and LN involvement (p = 0.028, HR 1.912) were the significant prognostic factors for RFS. CONCLUSIONS Our study demonstrated the superiority of adjuvant CCRT over chemotherapy for improving RFS in curatively resected BTC.

中文翻译：

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辅助同时放化疗和化疗对切除的胆道癌的疗效比较。

背景技术由于频繁的局部和远处复发，即使在根治性切除之后，胆道癌（BTC）的预后也很差。因此，已经提倡辅助治疗在BTC中的重要性，以改善预后。但是，辅助治疗的选择仍存在争议。这项研究的目的是比较辅助同时放化疗（CCRT）和化疗对切除的BTC的影响。方法我们分析了从2000年1月至2017年12月在Keimyung University Dongsan Medical Center接受根治性BTC切除并接受辅助CCRT或化学疗法的92例患者。结果在这些患者中，有46例接受了辅助CCRT，46例接受了辅助化疗。辅助CCRT组和化疗组的中位无复发生存期（RFS）分别为13.8和11.2个月（p = 0.014）。辅助CCRT和化疗组的中位总生存期（OS）分别为30.1和26.0个月（p = 0.222）。与化疗相比，辅助CCRT的RFS明显更好，OS数值更高。对于不涉及淋巴结（LN）（RFS p = 0.006，OS p = 0.420）或切除切缘阴性（RFS p = 0.042，OS p = 0.098）的亚组，辅助CCRT导致RFS明显更长，且OS数值高于化学疗法。对于多变量分析，辅助治疗的模式（化学疗法vs. CCRT，p = 0.004，HR 2.351），组织学分级（差或好，p = 0.023，HR 4.793）和LN参与（p = 0.028，HR 1.912）是RFS的重要预后因素。结论我们的研究表明辅助性CCRT优于化学疗法以改善根治性BTC的RFS。