Adjuvant chemotherapy with gemcitabine and S-1 after surgical resection for advanced biliary carcinoma: outcomes and prognostic factors.

Abstract

BACKGROUND/PURPOSE:

The aims of this study were to evaluate long-term outcomes and to determine prognostic factors for survival in patients with resected biliary carcinoma who received adjuvant gemcitabine plus S-1 chemotherapy.

METHODS:

Seventy patients with International Union Against Cancer (UICC) stage II, III, or IV biliary carcinoma received postoperative adjuvant chemotherapy consisting of intravenous gemcitabine 700 mg/m(2) on day 1 and oral S-1 60-100 mg/body for seven consecutive days, followed by a 1-week pause of chemotherapy. Patients received up to ten 2-week cycles. Long-term outcomes and predictors of survival with this adjuvant chemotherapy regimen were analyzed.

RESULTS:

The median duration of follow-up was 47 months. Fifty-six percent of patients had node-positive disease, and 80% of patients underwent R0 resection. Overall and disease-free survival rates were 91 and 81% at 1 year, 56 and 55% at 3 years, and 40 and 46% at 5 years, respectively. Lymph node status (p = 0.025) and surgical margin status (p = 0.033) were independently associated with long-term survival by multivariate analysis.

CONCLUSIONS:

Adjuvant gemcitabine plus S-1 chemotherapy may be a promising strategy for patients with resected biliary carcinoma, and nodal status and surgical margin status may be predictors of survival with this treatment strategy.

• Authors: Yoshiaki Murakami, Kenichiro Uemura, Takeshi Sudo, Yasushi Hashimoto, Akira Nakashima, Ryutaro Sakabe, Hironori Kobayashi, Naru Kondo, Naoya Nakagawa, Taijiro Sueda
• Journal: Journal of hepato-biliary-pancreatic sciences (J Hepatobiliary Pancreat Sci) Vol. 19 Issue 4 Pg. 306-13 (Jul 2012) ISSN: 1868-6982 [Electronic] Japan
• PMID: 22270151 (Publication Type: Journal Article)

Chemical References

• Antimetabolites, Antineoplastic
• Drug Combinations
• Deoxycytidine
• S 1 (combination)
• Tegafur
• Oxonic Acid
• Gemcitabine

Topics

• Adult
• Aged
• Aged, 80 and over
• Antimetabolites, Antineoplastic (therapeutic use)
• Bile Duct Neoplasms (drug therapy, surgery)
• Bile Ducts, Intrahepatic
• Biliary Tract Neoplasms (drug therapy, mortality, pathology, surgery)
• Chemotherapy, Adjuvant
• Cholangiocarcinoma (drug therapy, surgery)
• Deoxycytidine (analogs & derivatives, therapeutic use)
• Disease-Free Survival
• Drug Combinations
• Drug Therapy, Combination
• Female
• Humans
• Male
• Middle Aged
• Multivariate Analysis
• Neoplasm Recurrence, Local (epidemiology)
• Oxonic Acid (therapeutic use)
• Prognosis
• Proportional Hazards Models
• Tegafur (therapeutic use)
• Gemcitabine