Details

Autor(en) / Beteiligte

• Rangarajan, Karan
• Simmons, George
• Manas, Derek
• Malik, Hasan
• Hamady, Zaed Z.

Titel

Systemic adjuvant chemotherapy for cholangiocarcinoma surgery: A systematic review and meta-analysis

Ist Teil von

• European journal of surgical oncology, 2020-04, Vol.46 (4), p.684-693

Ort / Verlag

England: Elsevier Ltd

Erscheinungsjahr

2020

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• The role of adjuvant therapy for biliary tract cancer is not clearly defined with conflicting results demonstrated across nonrandomized and randomized studies. We report a systematic review and meta-analysis to delineate the effect of AT on overall survival. Eligible studies were identified from MEDLINE, EMBASE, Cochrane and PubMed. Studies comparing adjuvant chemotherapy or chemoradiotherapy after curative-intent surgery with curative surgery only for biliary tract cancer were included. Data pertaining to tumours of the gallbladder and bile ducts were included. The primary outcome assessed was overall survival. Random-effects meta-analysis was performed, as well as pooling of unadjusted Kaplan-Meier curve data. 35 studies involving 42,917 patients were analysed. There was a significant improvement in overall survival with any adjuvant therapy after surgery compared with surgery only (HR 0.74; 95% CI, 0.67 to 0.83; P < 0.001). There was a significant benefit for adjuvant therapy in those with margin positive surgery (RR, 0.83; 95% CI, 0.77 to 0.91; P < 0.001) and node-positive disease (RR 0.82; 95% CI 0.76 to 0.89; P < 0.001) Our review advocates the use of adjuvant therapy in bile duct cancer after curative intent resection. Further prospective studies are needed to determine the optimal regime and timing of an adjuvant approach. •Substantial contributions to conception and design, or acquisition of data, or analysis and interpretation of data: KR, GS, DM, HM, ZH.•Drafting the article or revising it critically for important intellectual content: KR, GS, DM, HM, ZH.•Final approval of the version to be published: KR, GS, DM, HM, ZH.