Researchers found improved longterm survival outcomes in patients with localized biliary tract cancers who received surgical resection alone when compared with multi-agent chemotherapy alone. Mohamedraed Elshami, MD, MMSc, and coinvestigators identified 5,988 patients with gallbladder adenocarcinoma, extrahepatic cholangiocarcinoma, and intrahepatic cholangiocarcinoma; 2,697 received multi-agent chemotherapy, and 3,291 had surgical resection. In patients with gallbladder adenocarcinoma or extrahepatic cholangiocarcinoma, surgical resection was associated with a decline in overall survival (OS) compared to patients who received multiagent chemotherapy within 30 days of treatment initiation (gallbladder adenocarcinoma [adjusted HR=3.94, 95% CI: 1.77-8.80]; extrahepatic cholangiocarcinoma [adjusted HR=4.88, 95% CI: 2.76-8.61]). However, there was an improvement in OS among patients treated with surgical resection 90 days after treatment initiation (gallbladder adenocarcinoma [adjusted HR=0.36, 95% CI: 0.28-0.46]; extrahepatic cholangiocarcinoma [adjusted HR=0.27, 95% CI: 0.24-0.32]). Meanwhile, patients with intrahepatic cholangiocarcinoma who received surgical resection showed improvements in OS.
