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Difficulty of adjuvant chemotherapy administration in patients with biliary tract cancer

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Abstract

Purpose

This study aimed to elucidate the difficulty of adjuvant chemotherapy administration in patients with biliary tract carcinoma (BTC).

Methods

Clinical data of patients with BTC who underwent curative-intent surgery were retrospectively analyzed. The eligible patients were stratified into two groups according to the presence or absence of adjuvant chemotherapy administration (adjuvant and non-adjuvant groups), and the clinicopathological features were compared between the two groups. The ratios of adjuvant chemotherapy administration were investigated in each surgical procedure. Independent factors associated with no administration of adjuvant chemotherapy were analyzed using multivariate analyses.

Results

Among 168 eligible patients, 141 (83.9%) received adjuvant chemotherapy (adjuvant group), while 27 (16.1%) did not (non-adjuvant group). The most common surgical procedure was pancreaticoduodenectomy in the adjuvant group, and it was hepatectomy with extrahepatic bile duct resection (BDR) in the non-adjuvant group, respectively. The rate of no adjuvant chemotherapy was significantly higher in patients who underwent hepatectomy with BDR than in those who underwent other surgeries (p < 0.001). The most common cause of no adjuvant chemotherapy was bile leak in 12 patients, which occurred after hepatectomy with BDR in ten patients. Multivariate analyses revealed that hepatectomy with BDR and preoperative anemia were independently associated with no adjuvant chemotherapy (p < 0.001 and p < 0.001, respectively).

Conclusions

Hepatectomy with BDR and subsequent refractory bile leak can be the obstacle to adjuvant chemotherapy administration in patients with BTC.

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Data availability

The datasets generated during this study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, 1‐2‐3 Kasumi, Minami‐ku, Hiroshima, 734‐8551, Japan

    Tatsuaki Sumiyoshi, Kenichiro Uemura, Ryuta Shintakuya, Kenjiro Okada, Kenta Baba, Takumi Harada & Shinya Takahashi

  2. Department of Gastroenterology and Metabolism, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan

    Masahiro Serikawa, Yasutaka Ishii & Shinya Nakamura

  3. Department of Anatomical Pathology, Hiroshima University, Hiroshima, Japan

    Koji Arihiro

  4. Digestive Disease Center, Hiroshima Memorial Hospital, Hiroshima, Japan

    Yoshiaki Murakami

Authors
  1. Tatsuaki Sumiyoshi
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  2. Kenichiro Uemura
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  6. Takumi Harada
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Contributions

T. S. and K. U. contributed to conception and design of the article. T. S., K. U., R. S., K. O., H. O., and K. B. analyzed data. T. S., K. U., R. S., M. S., Y. I., S. N., K. A., and Y. M. wrote the main manuscript text. T. S. and T. H. prepared the figures. T. S., K. U., K. O., T. H., K. B., and S. T. revised the manuscript. All authors reviewed and approved the final version to be published.

Corresponding author

Correspondence to Kenichiro Uemura.

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Sumiyoshi, T., Uemura, K., Shintakuya, R. et al. Difficulty of adjuvant chemotherapy administration in patients with biliary tract cancer. Langenbecks Arch Surg 408, 445 (2023). https://doi.org/10.1007/s00423-023-03169-9

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