Background/Objectives: Biliary tract cancers (BTCs) are aggressive malignancies with a poor prognosis. Surgery remains the only curative option, yet recurrence rates are high, and the role of adjuvant chemotherapy remains debated. This study aims to evaluate the impact of adjuvant chemotherapy and prognostic factors on survival outcomes in resected BTCs.Methods: We conducted a retrospective multicenter study analyzing patients diagnosed with intrahepatic (iCCA) and extrahepatic cholangiocarcinoma (eCCA) or gallbladder cancer (GBC) who underwent curative-intent surgical resection between 1999 and 2023. Demographic, clinicopathological, and treatment data were collected from institutional databases. Survival outcomes were assessed using Kaplan–Meier analysis, and prognostic factors were identified through Cox proportional hazards regression.Results: A total of 155 patients were included, with a median follow-up of 84.6 months. The cohort comprised 38.7% iCCA, 31.6% eCCA, and 29.7% GBC. R0 resection was achieved in 77.4% of cases, while lymph node involvement was present in 39.4%. Median overall survival (OS) significantly varied by stage (p< 0.001), ranging from >60 months for stage I to ~12 months for stage IVA. Eastern Cooperative Oncology Group (ECOG) performance status (PS) emerged as the strongest independent prognostic factor for OS (p< 0.001). Adjuvant chemotherapy, administered to 49.0% of patients, did not significantly improve OS in the overall cohort (p= 0.899). However, subgroup analyses suggested potential benefits in iCCA and eCCA but not in GBC. High CA19-9 levels and vascular invasion were associated with poorer survival outcomes.Conclusions: This study highlights the prognostic significance of ECOG PS, resection margin status, lymph node involvement, and CA19-9 levels in resected BTCs. The lack of a clear survival benefit from adjuvant chemotherapy underscores the need for improved therapeutic strategies. Future research should focus on refining risk stratification models and identifying more effective adjuvant treatments to enhance long-term survival outcomes in patients with BTC.
**背景/目的：** 胆道癌是一类侵袭性强、预后不良的恶性肿瘤。手术仍是唯一可能根治的手段，但复发率高，且辅助化疗的作用仍存争议。本研究旨在评估辅助化疗及预后因素对根治性切除术后胆道癌患者生存结局的影响。 **方法：** 我们进行了一项回顾性多中心研究，分析了1999年至2023年间诊断为肝内胆管癌、肝外胆管癌或胆囊癌并接受根治性手术切除的患者。从机构数据库中收集了人口统计学、临床病理学及治疗数据。采用Kaplan-Meier法评估生存结局，并通过Cox比例风险回归模型识别预后因素。 **结果：** 共纳入155例患者，中位随访时间为84.6个月。队列构成包括38.7%的肝内胆管癌、31.6%的肝外胆管癌和29.7%的胆囊癌。77.4%的病例实现了R0切除，39.4%存在淋巴结受累。中位总生存期随分期不同而存在显著差异（p < 0.001），从I期的>60个月到IVA期的约12个月不等。东部肿瘤协作组体能状态评分被确定为总生存期最强的独立预后因素（p < 0.001）。49.0%的患者接受了辅助化疗，但在整个队列中并未显著改善总生存期（p = 0.899）。然而，亚组分析提示辅助化疗在肝内胆管癌和肝外胆管癌患者中可能有益，但在胆囊癌患者中未见此效应。高CA19-9水平和血管侵犯与较差的生存结局相关。 **结论：** 本研究强调了ECOG体能状态评分、切缘状态、淋巴结受累和CA19-9水平在根治性切除术后胆道癌患者中的预后意义。辅助化疗未能带来明确的生存获益，突显了改进治疗策略的必要性。未来的研究应侧重于完善风险分层模型，并寻找更有效的辅助治疗方案，以提高胆道癌患者的长期生存结局。
肿瘤(癌症)患者之家