- Adjuvant therapy is associated with better survival in biliary tract cancer than surgery alone.
Why this matters
- Overall analysis and analysis of randomized trials alone yield similar results.
- Meta-analysis of 35 studies (n=42,917; surgery alone, n=27,046; adjuvant therapy, n=15,871).
- Funding: NIHR BRC Southampton.
- Adjuvant therapy was associated with better survival than surgery alone (HR, 0.74; P<.001>
- A subgroup analysis that included only randomized controlled trials (5 trials) also showed a benefit (HR, 0.81; P<.001>
- Sensitivity analyses showed a similar benefit of adjuvant therapy whether it took the form of chemotherapy or chemoradiotherapy:
- Gallbladder cancer: chemotherapy HR, 0.87 (P=.037); chemoradiotherapy HR, 0.51 (P=.017).
- Bile duct cancer: chemotherapy HR, 0.77 (P<.001 chemoradiotherapy hr>
- Kaplan-Meier data showed that adjuvant therapy was associated with a median survival:
- Gallbladder cancer: 31.5 (95% CI, 30-33) months vs 19.3 (95% CI, 18.8-19.8) months with surgery alone (P<.001>
- Bile duct cancer: 42.4 (95% CI, 39.7-44.9) months vs 39 (95% CI, 36-40.5) months with surgery alone (P=.0066).
- Most included studies were cohort studies.