Adjuvant Treatment and Follow-up Strategies

Despite radical resection, the five-year overall survival rate for cholangiocarcinoma does not exceed 40% in the best surgical series. To date, adjuvant tratments such as radiotherapy, chemotherapy or a combination of both have been explored but mainly in small retrospective series. Available data indicate that chemotherapy can reduce the risk od distant relapse while radiotherapy can decrease the risk of local failure. The benefits of chemotherapy and radiotherapy seem to be greated for high-risk patients such as those with nodal involvement or microscopically non-radical resection, whereas the overall effects of adjuvant treatment are less clear for average risk patiens. Ongioing randomised trials will definitively clarify the value and overall benefit of adjuvant treatments in bilary tract cancer.In the absence of literature evidence, the purpose of follow-up care must be discussed with the patients to devise an individualized treatment strategy.