Changes to This Summary (08/19/2011)

The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.

General Information About Extrahepatic Bile Duct Cancer

Added image to include the extrahepatic bile duct anatomy.

Unresectable, Recurrent, or Metastatic Extrahepatic Bile Duct Cancer

Revised section title to include "Recurrent, or Metastatic."

Added text to state that the majority of patients who undergo resection will develop recurrent disease within the hepatobiliary system or less frequently at distant sites.

Added text to state that patients may be candidates for inclusion in clinical trials that explore ways to improve the effects of radiation therapy with various radiation sensitizers, such as hyperthermia, radiosensitizer drugs, or cytotoxic chemotherapeutic agents.

Added text about the use of systemic chemotherapy as a treatment option that is appropriate for selected patients with adequate performance status and intact organ function, and that fluoropyrimidines, gemcitabine, platinum agents, and docetaxel have been reported to produce transient partial remissions in a minority of patients.

Added text to state that a randomized phase III study of up to 6 months of gemcitabine versus gemcitabine and cisplatin in 410 patients with unresectable, recurrent, or metastatic biliary tract carcinoma demonstrated an improvement in median overall survival (OS) among patients treated with combination therapy (cited Valle et al. as reference 5 and level of evidence 1iiA). Also added that a similar median OS benefit was demonstrated in all subgroups and grade 3 and 4 toxicities occurred with similar frequency in both study arms, with the exception of increased hematologic toxicity in patients randomly assigned to gemcitabine-cisplatin and increased hepatotoxicity in patients randomly assigned to single-agent gemcitabine; concluded that other drugs and drug combinations await evaluation in randomized trials.