Current status and issues of adjuvant and neoadjuvant chemotherapy for bile duct cancers

Abstract

Surgical resection is the only curative treatment for biliary tract cancers, but there are many cases of postoperative recurrence and unresectable cases at the time of diagnosis, and conversion surgery has recently been focused on, so chemotherapy plays a major role. Large-scale clinical trials of chemotherapy for biliary tract cancer have been difficult due to differences in surgical procedures and surgical invasiveness depending on tumor location and tumor extension. However, some evidence is accumulating regarding adjuvant chemotherapy, and postoperative S-1 administration will be recommended in the next revision of "Clinical practice guidelines for the management of biliary tract cancers: The 4th edition". On the other hand, the criteria for neoaduvant chemotherapy including conversion surgery has not been recommended yet. In this article, we review the clinical trials of chemotherapy for biliary tract cancer, and discuss future prospects and problems.