Even though S-1 is a widely used chemotherapeutic agent, there is no evidence for its use in an adjuvant setting for biliary tract carcinoma (BTC). Patients who underwent surgical treatment for BTC between August 2007 and December 2018 were selected. Propensity score matching was performed between patients who received S-1 as adjuvant chemotherapy (S-1 group) and those who underwent surgical treatment alone (observation group). Of 170 eligible patients, 38 patients were selected in each group after propensity score matching. Among those in the matched cohort, both the median recurrence-free survival (RFS) and overall survival (OS) in the S-1 group were significantly longer than those in the observation group (RFS, 61.2 vs. 13.1 months, p = 0.033; OS, not available vs. 28.2 months, p = 0.003). A multivariate analysis of the OS revealed that perineural invasion and adjuvant S-1 chemotherapy were independent prognostic factors. According to a subgroup analysis of the OS, the S-1 group showed significantly better prognoses than the observation group among patients with perineural invasion (p < 0.001). S-1 adjuvant chemotherapy might improve the prognosis of BTC, especially in patients with perineural invasion.

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Introduction: The metabolome represents the final stage in the "omics" cascade and is may be the closest phenotype to the biological behavior of cancer. Thus, we investigated potential clinical applications of preoperative serum metabolomes in predicting recurrence in patients with resected pancreatic cancer. Method: From November 2012 to June 2014, patients who underwent potentially curative pancreatectomy for pancreatic ductal adenocarcinoma were examined. We evaluated the clinical application of preoperative serum metabolomes in predicting cancer recurrence and the relationships between metabolomes and tumor markers to propose a nomogram Result: Among 57 patients, 32 were men; Forty-two patients had pancreatic head cancers. The 57 patients could be clearly categorized into two main clusters using 157 preoperative serum metabolomes. Patients within cluster 2 showed early tumor recurrence compared with those within cluster 1 (p=0.034). A nomogram was developed for predicting the probability of early diseasefree survival in patients with resected pancreatic cancer. Preoperative cancer antigen (CA) 19-9 levels and serum metabolomes PC.aa.C38_4, PC.ae.C42_5, and PC.ae.C38_6 were the most powerful preoperative clinical variables to predict 6-month or 1-year cancer recurrence-free survival after radical pancreatectomy, with Harrell's concordance index of 0.823 (95% CI: 0.750e 0.891) and integrated area under the curve of 0.816 (95% CI: 0.736e0.893). Conclusion:Patients with resected pancreatic cancer could be categorized according to their different metabolomes to predict early cancer recurrence. Preoperative detectable parameters, serum CA 19-9, PC.aa.C38_4, PC.ae.C42_5, and PC.ae.C38_6 were the most powerful predicting factors for early recurrence of pancreatic cancer.

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