Randomized clinical trial of adjuvant gemcitabine chemotherapy versus observation in resected bile duct cancer. BJS 2018; 105: 192-202.
Published: 5th February 2018
Authors: T. Ebata, S. Hirano, M. Konishi, K. Uesaka, Y. Tsuchiya, M. Ohtsuka et al.
Although some retrospective studies have suggested the value of adjuvant therapy, no recommended standard exists in bile duct cancer. The aim of this study was to test the hypothesis that adjuvant gemcitabine chemotherapy would improve survival probability in resected bile duct cancer.
This was a randomized phase III trial. Patients with resected bile duct cancer were assigned randomly to gemcitabine and observation groups, which were balanced with respect to lymph node status, residual tumour status and tumour location. Gemcitabine was given intravenously at a dose of 1000 mg/m2, administered on days 1, 8 and 15 every 4 weeks for six cycles. The primary endpoint was overall survival, and secondary endpoints were relapse‐free survival, subgroup analysis and toxicity.
Some 225 patients were included (117 gemcitabine, 108 observation). Baseline characteristics were well balanced between the gemcitabine and observation groups. There were no significant differences in overall survival (median 62·3
The survival probability in patients with resected bile duct cancer was not significantly different between the gemcitabine adjuvant chemotherapy group and the observation group. Registration number: UMIN 000000820 (
You may also be interested in
Neoadjuvant chemotherapy response influences outcomes in non‐colorectal, non‐neuroendocrine liver metastases.
Authors: A. M. Lucchese, A. N. Kalil, A. Ruiz, V. Karam, O. Ciacio, G. Pittau et al.
Notes: Multimodal therapy works
Authors: B. Groot Koerkamp, W. R. Jarnagin
Development and validation of a difficulty score to predict intraoperative complications during laparoscopic liver resection. BJS 2018; 105: 1182-1191.
Authors: M. C. Halls, G. Berardi, F. Cipriani, L. Barkhatov, P. Lainas, S. Harris et al.
Notes: Helps improve selection for laparoscopic liver resection
Validation of at least 1 mm as cut‐off for resection margins for pancreatic adenocarcinoma of the body and tail. BJS 2018; 105: 1171-1181.
Authors: T. Hank, U. Hinz, I. Tarantino, J. Kaiser, W. Niesen, F. Bergmann et al.
Notes: Validated for R0
Meta‐analysis comparing upfront surgery with neoadjuvant treatment in patients with resectable or borderline resectable pancreatic cancer. BJS 2018; 105: 946-958.
Authors: E. Versteijne, J. A. Vogel, M. G. Besselink, O. R. C. Busch, J. W. Wilmink, J. G. Daams et al.
Notes: Improved survival with neoadjuvant treatment
Genetic And Morphological Evaluation (GAME) score for patients with colorectal liver metastases. BJS 2018; 105: 1210-1220.
Authors: G. A. Margonis, K. Sasaki, S. Gholami, Y. Kim, N. Andreatos, N. Rezaee et al.
Notes: Predicts survival
Reappraisal of classification of distal cholangiocarcinoma based on tumour depth. BJS 2018; 105: 867-875.
Authors: H. Aoyama, T. Ebata, M. Hattori, M. Takano, H. Yamamoto, M. Inoue et al.
Notes: Better for T staging
Prediction of major complications after hepatectomy using liver stiffness values determined by magnetic resonance elastography. BJS 2018; 105: 1192-1199.
Authors: N. Sato, A. Kenjo, T. Kimura, R. Okada, T. Ishigame, Y. Kofunato et al.
Notes: liver stiffness predicts complications
Randomized clinical trial
Randomized clinical trial of the effect of a fibrin sealant patch on pancreatic fistula formation after pancreatoduodenectomy. BJS 2018; 105: 811-819.
Authors: M. Schindl, R. Függer, P. Götzinger, F. Längle, M. Zitt, S. Stättner et al.
Notes: Not effective in reducing complications
Prognostic impact of perihepatic lymph node metastases in patients with resectable colorectal liver metastases. BJS 2018; 105: 1200-1209.
Authors: M. Okuno, C. Goumard, T. Mizuno, S. Kopetz, K. Omichi, C.‐W. D. Tzeng et al.
Notes: Bad sign of advanced disease
Trends in use of lymphadenectomy in surgery with curative intent for intrahepatic cholangiocarcinoma. BJS 2018; 105: 857-866.
Authors: X.‐F. Zhang, J. Chakedis, F. Bagante, Q. Chen, E. W. Beal, Y. Lv et al.
Notes: Lymphadenectomy is important
Meta‐analysis of an artery‐first approach versus standard pancreatoduodenectomy on perioperative outcomes and survival. BJS 2018; 105: 628-636.
Authors: N. Ironside, S. G. Barreto, B. Loveday, S. V. Shrikhande, J. A. Windsor, S. Pandanaboyana et al.
Notes: Benefits to artery‐first approach