Abstract
Although the primary therapeutic strategy for bile duct cancer is surgical resection, around 60% of resected cases have any kinds of prognostic factors, such as positive lymph node metastasis and positive surgical margins. Thus, these patients may be potential candidates for adjuvant therapy. Many clinical trials seeking feasibility and clinical benefits of adjuvant therapy were conducted. However, most of them were single-center clinical trial consisting of small number of patients with tumors existing in different anatomical sites. There was no firm evidence of clinical usefulness of adjuvant therapy until now. Publication of multi-center prospective randomized study is long-awaited. Concerning neoadjuvant and down-staging chemotherapy for initially unresectable or borderline resectable bile duct cancer, its clinical benefits have not yet been proven. In the near future, development of multi-drug regimen using cytotoxic agents and targeted therapies based on particular biomarkers are expected.
