The prognosis of patients with
biliary tract cancer remains unsatisfactory even with surgery owing to the high recurrence rate. Therefore, an effective
adjuvant chemotherapy is required to prolong survival. A few randomized controlled trials in patients with limited
biliary tract cancer have been reported, but the efficacy of
adjuvant chemotherapy could not be clarified. To date, effective
adjuvant chemotherapy with evidence has not been established, and the standard
therapy for patients with resectable
biliary tract cancer has only been surgical treatment. Recently, a number of newer toxic agents have been shown to induce response in patients with advanced
biliary tract cancer. Moreover, the morbi-mortality rate of operation for this
cancer has been decreasing owing to advances in operative techniques and perioperative management. Given this background, a number of
adjuvant chemotherapy trials have been started using
gemcitabine,
capecitabine, S-1, and
combination chemotherapy with
platinum. The results of these trials will be reported in the near future. Overall, the important aspects of
adjuvant chemotherapy for
biliary tract cancer are to establish well-organized and active clinical trial study groups, to conduct well-designed multicenter randomized controlled trials, and to continue such trials without interruption in the future.