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Clinical results of intra-arterial adjuvant chemotherapy for prevention of liver metastasis following curative resection of biliary tract cancer
Authors:Hayashibe A  Kameyama M
Affiliation:Department of Surgery, Bell Land General Hospital, Sakai City, Osaka, Japan. akirah1@hotmail.com
Abstract:Background. This is a report on the clinical results of intra-arterial adjuvant chemotherapy in the prevention of liver metastasis following curative resection of biliary tract cancer. Methods. Nineteen patients of advanced biliary tract underwent a pathologically radical operation between 2001 and 2006 (8 M and 11 F; mean age 66.2 years). Intra-arterial adjuvant chemotherapy with CDDP and 5-FU was performed selectively for 9 patients. The control group comprised 10 patients. Age, gender, staging of the disease, resection of the portal vein, postoperative radiotherapy, histological liver invasion as demographics and clinical characteristics were compared between the two groups. Results. Demographics and clinical characteristics were similar in the two groups. Liver metastasis occurred in 4 of 9 patients (44.4%) in the chemotherapy group and in 5 of 10 patients (50%) in the control group. There was no difference in the rate of liver metastasis between the two groups. The median survival term was 23.3 months for 9 patients who underwent the intra-arterial adjuvant chemotherapy, whereas the median survival term for 10 patients who were curatively resected without intra-arterial adjuvant chemotherapy was 21.7 months. The median survival term was statistically similar in both groups. Furthermore, in the recurrence-free survival, there was no major difference between the chemotherapy and control groups statistically. Conclusions. In the patients with advanced biliary tract cancer who underwent the curative operation, the intra-arterial adjuvant chemotherapy could not suppress the rate of liver metastasis nor improve cumulative survival.
Keywords:Biliary tract cancer   intra-arterial chemotherapy   adjuvant therapy
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