Adjuvant treatment after resection of biliary-tract cancer: yes or no?
AbstractBiliary-tract cancers are rare tumors and carry poor prognosis despite some aggressive surgical approach. The benefit of adjuvant treatment is under debate, and except one there is no phase III trial available. However, it appears that, in a large proportion, adjuvant therapy is proposed to patient. It could be chemotherapy or radiotherapy alone or both. Many publications are available on this topic. These are sometimes phase II studies, but mostly retrospective data about the experience of one center. All these studies have got many bias and the results must be interpreted with caution, even if patients could get some benefit of adjuvant therapy in case of adverse prognostic factors as positive resection margin and/or nodal involvement. In this review, we sum up the different therapies used as adjuvant treatment for biliary-tract cancer, and then we have studied what is done in clinical practice in order to propose a phase III clinical trial in this setting.
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Copyright (c) 2011 Eveline Boucher, Marc Pracht, Catherine Le Roux, Karim Boudjema, Jean-Luc Raoul
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