Adjuvant Therapy for Resected Biliary Tract Cancer

Publication Date: March 11, 2019
Last Updated: December 15, 2022


Patients with resected biliary tract cancer should be offered adjuvant capecitabine chemotherapy for a duration of 6 months. ( EB , H , H , M )
Qualifying statements:
  • In the BILCAP phase III randomized controlled trial, capecitabine was delivered at a dose of 1250 mg/m2 twice/day on treatment day 1 to 14 of a 3-weekly cycle for 24 weeks (8 cycles).
  • The Expert Panel agrees that the recommended dose of capecitabine may be determined by institutional and regional practices.

Patients with extrahepatic cholangiocarcinoma or gallbladder cancer and a microscopically positive surgical margin resection (R1 resection) may be offered chemoradiation therapy (CRT). ( EB , H , B/H , W )
Qualifying statements:
  • A shared decision-making approach is recommended, considering the risk of potential harm and potential for benefit associated with radiation therapy for patients with extrahepatic cholangiocarcinoma or gallbladder cancer.
  • The Expert Panel notes that in the SWOG0809 prospective single-arm trial of CRT, radiation was delivered at a dose of 45 Gy to regional lymphatics and 54 to 59.4 Gy to the tumor bed. However, at this time, the evidence base is not sufficiently well-developed to make a recommendation for optimal dosing of radiation therapy in the context of CRT.

Recommendation Grading




Adjuvant Therapy for Resected Biliary Tract Cancer

Authoring Organization

Publication Month/Year

March 11, 2019

Last Updated Month/Year

December 15, 2022

Document Type


External Publication Status


Country of Publication


Target Patient Population

Patients with resected biliary tract cancer.

Target Provider Population

Oncologists (medical, radiation, and surgical) and other health care professionals

Inclusion Criteria

Female, Male, Adolescent, Adult, Child, Older adult

Health Care Settings

Ambulatory, Hospital, Outpatient, Radiology services

Intended Users

Nurse, nurse practitioner, physician, physician assistant


Management, Treatment


biliary tract cancer, Resected, Adjuvant Therapy, intrahepatic bile ducts

Source Citation

DOI: 10.1200/JCO.18.02178 Journal of Clinical Oncology 37, no. 12 (April 20, 2019) 1015-1027.

Supplemental Methodology Resources

Data Supplement


Number of Source Documents
Literature Search Start Date
January 1, 2008
Literature Search End Date
June 30, 2018