Adjuvant therapy for resected biliary tract cancer: a review

Surgical resection remains the most important treatment for patients with biliary tract cancer (BTC), but despite radical surgical techniques many patients ultimately develop recurrent disease. BTC encompasses several distinct disease entities—intrahepatic, perihilar and distal bile duct cholangiocarcinoma as well as gallbladder cancer. These tumors are histologically similar, but have different etiologies and recent information regarding their genomic footprint has questioned their biological similarity. Surgical approaches are also necessarily varied based on the site of the tumor. Due to the poor survival rates seen in this disease, there has been significant effort to investigate chemotherapy and radiotherapy as adjuvants in patients whose disease has been successfully resected. The majority of the published evidence supporting this treatment relies on retrospective series or limited prospective studies, making interpretation difficult and complicating treatment decisions. This review summarizes the data regarding these adjunctive therapies.