Adjuvant Therapy in the Treatment of Biliary Tract Cancer A Systematic Review and Meta-AnalysisAdjuvant Therapy in the Treatment of Biliary Tract Cancer A Systematic Review and Meta-Analysis

SUMMARY: The authors in this meta-analysis reviewed data on 6712 patients with biliary tract cancers, including gall bladder tumors. Ampullary tumors were excluded. These patients had resections done with a curative intent and this was defined as those with negative surgical margins (R0) or microscopic positive margins (R1). All these patients received adjuvant therapy, which included chemotherapy, radiation therapy or a combination of both, following surgery. There was an improvement in overall survival for those patients receiving adjuvant therapy. Patients who received chemotherapy or chemoradiation treatment derived greater benefit than those who received radiation therapy alone. The greatest statistically significant benefit was seen in those with lymph node positive disease and R1 disease. Based on this analysis, it may be reasonable to consider adjuvant therapy for patients with high risk biliary tract cancers. Horgan AM, Amir E, Walter T, et al. JCO  2012; 30:1934-1940