The efficiency and regimen choice of adjuvant chemotherapy in biliary tract cancer: A STROBE-compliant retrospective cohort study.

Biliary tract cancer (BTC) patients have poor prognosis even following radical resection. To improve the current status, more evidence is required clarifying the role of adjuvant chemotherapy. This study aim is to evaluate the efficacy of adjuvant chemotherapy and discuss the regimen choices. We retrospectively analyzed the clinical data of 80 patients who underwent curative-intent R0 resection from 2008 to 2016. Among them, 40 patients had received adjuvant chemotherapy, and the others in the observation group were 1: 1 matched by clinical characteristics including gender, age, tumor stage, and ECOG performance status score. Kaplan-Meier analysis was performed to compare DFS and OS. Potential confounding factors were adjusted by Multivariate analysis. In the entire patient cohort, the mean disease-free survival (DFS) time of BTC patients with adjuvant chemotherapy and observation was 18.63 +/- 3.63 months versus 10.36 +/- 1.67 months, respectively (P=.029). There was no significant difference observed in overall survival (OS) time (33.72 +/- 5.02 vs 21.05 +/- 4.12 months, P=.114). On multivariate analysis, adjuvant chemotherapy and N factor were found to be significant factors for DFS, and sex, age, T factor were found to be significant factors for OS. Besides, subgroup analysis indicated that combination chemotherapy prolonged DFS time of BTC patients than single-agent to some extent, and oral agents showed efficacy to improve OS. This retrospective study demonstrates that adjuvant chemotherapy contributes to DFS, but is unsatisfactory for improving OS. Combination chemotherapy contained oral agents provides a possibility of therapeutic strategy for improving surgical outcomes of BTC patients.