The efficacy and safety of 5-fluorouracil based adjuvant therapy in resected biliary tract cancer: A systematic review and meta-analysis - 27/02/22
, Tiankang Guo a, ⁎ Bienvenue sur EM-consulte, la référence des professionnels de santé.
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| pages | 12 |
| Iconographies | 4 |
| Vidéos | 0 |
| Autres | 0 |
Highlights |
• | The risk of recurrence is as high as 60-70% in the patients who underwent surgical resection in bile duct cancer. |
• | The 5-FU regimen is still widely used in digestive system tumors, but no meta-analysis had so far been published to provide the conclusion of evidence-based medicine |
• | This study was performed based on the Cochrane Handbook for Systematic Reviews of Interventions and PRISMA guidelines |
Abstract |
Objectives |
The adjuvant therapy (AT) for biliary tract cancer (BTC) patients after surgery has always been controversial. More therapeutic regimens and high-quality evidence were needed to evaluate AT's survival benefit further. Thus, this study was performed to investigate the efficacy and safety of the 5-fluorouracil (5-FU) regimen in resected BTC patients.
Methods |
PubMed, Cochrane Library, Web of Science, and the Embase were systematically searched from inception to Feb.3, 2021, for eligible studies. The pooled analyses were performed using Review Manager, Stata, and SPSS software.
Results |
A total of 9 trials involving 1339 participants were included in the meta-analysis. Resected BTC patients could significantly benefit from a 5-FU regimen (HR:0.51, 95%CI, 0.38-0.69, P<0.0001), regardless of gallbladder carcinoma (GBC) or cholangiocarcinoma (CCA). Moreover, both adjuvant chemotherapy (HR:0.61, 95%CI, 0.47-0.79, P=0.0003) and chemoradiotherapy (HR:0.35, 95%CI, 0.14-0.83, P=0.02) could significantly improve clinical survival of resected BTC patients than the surgery alone group. In the subgroup analyses, patients with node-positive (P=0.02) or vascular invasion disease (P=0.002) could better benefit from postoperative AT.
Conclusion |
This study provides the latest evidence to support the 5-FU regimen in resected BTC patients regardless of GBC or CCA. Furthermore, high-risk patients are more likely to benefit from it, such as node-positive or vascular invasion disease.
Le texte complet de cet article est disponible en PDF.Keywords : Biliary tract cancer, 5-Fluorouracil, Adjuvant therapy, Surgery alone, Meta-analysis
Abbreviation : 5-FU, AT, BTC, CCA, CI, CRT, CT, DFS, GBC, HR, I2, NOS, OR, OS, P, PRISMA, RCT, RFS
Plan
Vol 46 - N° 2
Article 101788- février 2022 Retour au numéro
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