Michele Ghidini1, Gianluca Tomasello1, Andrea Botticelli2, Sandro Barni3, Giampietro Zabbialini4, Silvia Seghezzi5, Rodolfo Passalacqua1, Chiara Braconi6, Fausto Petrelli7. 1. Oncology Unit, Oncology Department, ASST Cremona, Cremona, Italy. 2. Clinical and Molecular Medicine Department, Sapienza University and Sant' Andrea Hospital, Rome, Italy. 3. Oncology Unit, Oncology Department, ASST Bergamo Ovest, Treviglio, BG, Italy. 4. Surgical Oncology Unit, Surgery Department, ASST Bergamo Ovest, Treviglio, BG, Italy. 5. Nuclear Medicine Unit, Radiology Department, ASST Bergamo Ovest, Treviglio, BG, Italy. 6. Division of Cancer Therapeutics, The Institute of Cancer Research, London, UK; Department of Medicine, The Royal Marsden NHS Trust, London, UK. 7. Oncology Unit, Oncology Department, ASST Bergamo Ovest, Treviglio, BG, Italy. Electronic address: faupe@libero.it.
Abstract
INTRODUCTION: The use of adjuvant treatment (AT) in resected biliary tract cancers (BTC) is still controversial. No efficacy comparison has been performed between chemotherapy (CT) and chemoradiotherapy (CTRT). A systematic review of the available evidence regarding adjuvant chemotherapy (AC) in resected BTC was performed. METHODS: PubMed, EMBASE, Web of Science, SCOPUS and The Cochrane Library databases were searched for relevant articles published. Only studies including at least 50 patients affected by tumors of gallbladder, intrahepatic, perihilar, and distal bile ducts were considered. Data were pooled using a random-effects model. The primary endpoint of the study was overall survival (OS). RESULTS: Thirty studies were analyzed with a total of 22,499 patients, 3967 of whom received AC. Eleven cohorts included Western patients and 19 were Asiatic. Surgeries were classified as R0 with negative margins, R1 with positive microscopic and R2 with positive macroscopic margins. Weighted mean OS difference among experimental (AC) and control arm was 4.3 months (95% CI 0.88-7.79, P = 0.014). AC reduced the risk of death by 41% (Hazard ratio [HR] = 0.59, 95% CI 0.49-0.71; P < 0.001). CONCLUSIONS: AC administration gives an OS benefit in resected BTC. The results of prospective randomized studies are awaited in order to define the standard AT in BTC.
INTRODUCTION: The use of adjuvant treatment (AT) in resected biliary tract cancers (BTC) is still controversial. No efficacy comparison has been performed between chemotherapy (CT) and chemoradiotherapy (CTRT). A systematic review of the available evidence regarding adjuvant chemotherapy (AC) in resected BTC was performed. METHODS: PubMed, EMBASE, Web of Science, SCOPUS and The Cochrane Library databases were searched for relevant articles published. Only studies including at least 50 patients affected by tumors of gallbladder, intrahepatic, perihilar, and distal bile ducts were considered. Data were pooled using a random-effects model. The primary endpoint of the study was overall survival (OS). RESULTS: Thirty studies were analyzed with a total of 22,499 patients, 3967 of whom received AC. Eleven cohorts included Western patients and 19 were Asiatic. Surgeries were classified as R0 with negative margins, R1 with positive microscopic and R2 with positive macroscopic margins. Weighted mean OS difference among experimental (AC) and control arm was 4.3 months (95% CI 0.88-7.79, P = 0.014). AC reduced the risk of death by 41% (Hazard ratio [HR] = 0.59, 95% CI 0.49-0.71; P < 0.001). CONCLUSIONS: AC administration gives an OS benefit in resected BTC. The results of prospective randomized studies are awaited in order to define the standard AT in BTC.
Authors: Sara Massironi; Lorenzo Pilla; Alessandra Elvevi; Raffaella Longarini; Roberta Elisa Rossi; Paolo Bidoli; Pietro Invernizzi Journal: Cells Date: 2020-03-11 Impact factor: 6.600
Authors: Daniele Dondossola; Michele Ghidini; Francesco Grossi; Giorgio Rossi; Diego Foschi Journal: World J Gastroenterol Date: 2020-07-07 Impact factor: 5.742