Role of adjuvant chemoradiotherapy for resected extrahepatic biliary tract cancer

Int J Radiat Oncol Biol Phys. 2011 Dec 1;81(5):e853-9. doi: 10.1016/j.ijrobp.2010.12.019. Epub 2011 Apr 15.


Purpose: To evaluate the effect of adjuvant chemoradiotherapy (CRT) on locoregional control (LRC), disease-free survival (DFS), and overall survival (OS) for patients with extrahepatic biliary tract cancer treated with curative resection.

Methods and materials: The study involved 168 patients with extrahepatic biliary tract cancer undergoing curative resection between August 2001 and April 2009. Of the 168 patients, 115 received adjuvant CRT (CRT group) and 53 did not (no-CRT group). Gender, age, tumor size, histologic differentiation, pre- and postoperative carbohydrate antigen 19-9 level, resection margin, vascular invasion, perineural invasion, T stage, N stage, overall stage, and the use of adjuvant CRT were analyzed to identify the prognostic factors associated with LRC, DFS, and OS.

Results: For all patients, the 5-year LRC, DFS, and OS rate was 54.8%, 30.6%, and 33.9%, respectively. On univariate analysis, the 5-year LRC, DFS, and OS rates in the CRT group were significantly better than those in the no-CRT group (58.5% vs. 44.4%, p=.007; 32.1% vs. 26.1%, p=.041; 36.5% vs. 28.2%, p=.049, respectively). Multivariate analysis revealed that adjuvant CRT was a significant independent prognostic factor for LRC, DFS, and OS (p<.05).

Conclusion: Our results have suggested that adjuvant CRT helps achieve LRC and, consequently, improves DFS and OS in patients with extrahepatic biliary tract cancer.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Bile Duct Neoplasms / mortality
  • Bile Duct Neoplasms / pathology
  • Bile Duct Neoplasms / surgery
  • Bile Duct Neoplasms / therapy*
  • Bile Ducts, Extrahepatic* / pathology
  • Bile Ducts, Extrahepatic* / surgery
  • CA-19-9 Antigen / blood
  • Chemoradiotherapy, Adjuvant* / adverse effects
  • Disease-Free Survival
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Prognosis
  • Radiation Injuries / complications
  • Retrospective Studies
  • Sex Factors
  • Tumor Burden


  • CA-19-9 Antigen