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- Title
Difficulty of adjuvant chemotherapy administration in patients with biliary tract cancer.
- Authors
Sumiyoshi, Tatsuaki; Uemura, Kenichiro; Shintakuya, Ryuta; Okada, Kenjiro; Baba, Kenta; Harada, Takumi; Serikawa, Masahiro; Ishii, Yasutaka; Nakamura, Shinya; Arihiro, Koji; Murakami, Yoshiaki; Takahashi, Shinya
- Abstract
Purpose: This study aimed to elucidate the difficulty of adjuvant chemotherapy administration in patients with biliary tract carcinoma (BTC). Methods: Clinical data of patients with BTC who underwent curative-intent surgery were retrospectively analyzed. The eligible patients were stratified into two groups according to the presence or absence of adjuvant chemotherapy administration (adjuvant and non-adjuvant groups), and the clinicopathological features were compared between the two groups. The ratios of adjuvant chemotherapy administration were investigated in each surgical procedure. Independent factors associated with no administration of adjuvant chemotherapy were analyzed using multivariate analyses. Results: Among 168 eligible patients, 141 (83.9%) received adjuvant chemotherapy (adjuvant group), while 27 (16.1%) did not (non-adjuvant group). The most common surgical procedure was pancreaticoduodenectomy in the adjuvant group, and it was hepatectomy with extrahepatic bile duct resection (BDR) in the non-adjuvant group, respectively. The rate of no adjuvant chemotherapy was significantly higher in patients who underwent hepatectomy with BDR than in those who underwent other surgeries (p < 0.001). The most common cause of no adjuvant chemotherapy was bile leak in 12 patients, which occurred after hepatectomy with BDR in ten patients. Multivariate analyses revealed that hepatectomy with BDR and preoperative anemia were independently associated with no adjuvant chemotherapy (p < 0.001 and p < 0.001, respectively). Conclusions: Hepatectomy with BDR and subsequent refractory bile leak can be the obstacle to adjuvant chemotherapy administration in patients with BTC.
- Subjects
BILIARY tract cancer; ADJUVANT chemotherapy; GALLBLADDER cancer; BILIARY tract; CHOLANGIOGRAPHY; BILE ducts; OPERATIVE surgery
- Publication
Langenbeck's Archives of Surgery, 2023, Vol 408, Issue 1, p1
- ISSN
1435-2443
- Publication type
Article
- DOI
10.1007/s00423-023-03169-9