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Int J Radiat Oncol Biol Phys. 2009 Sep 1;75(1):150-5. doi: 10.1016/j.ijrobp.2008.10.052. Epub 2009 Mar 16.

Adjuvant therapy for gallbladder carcinoma: the Mayo Clinic Experience.

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1
Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota 55905, USA.

Abstract

PURPOSE:

To analyze the effect of adjuvant chemoradiotherapy on gallbladder carcinoma.

METHODS AND MATERIALS:

We retrospectively reviewed the records from consecutive patients who underwent R0 resection of gallbladder carcinoma between January 1, 1985, and December 31, 2004. Patients had either Stage I (T1-T2N0M0) or Stage II (T3N0M0 or T1-T3N1M0) disease. Patients undergoing adjuvant therapy received 5-fluorouracil chemotherapy concurrently with radiotherapy (median dosage, 50.4 Gy in 28 fractions). Adverse prognostic factors and the effect of adjuvant treatment on overall survival (OS) were evaluated.

RESULTS:

A total of 73 patients were included in the analysis; of these, 25 received adjuvant chemoradiotherapy. On univariate analysis, no adverse prognostic factors for OS reached statistical significance, but trends were noted for Stage N1 vs. N0 (p = .06), Nx vs. N0 (p = .09), Stage T3 vs. T1-T2 (p = .06), and histologic findings other than adenocarcinoma (p = .13). The median OS for patients receiving adjuvant chemoradiotherapy vs. surgery alone was 4.8 years and 4.2 years, respectively (log-rank test, p = .56). However, a significantly greater percentage of patients receiving adjuvant chemoradiotherapy had Stage II disease (p <.001). In the multivariate Cox model, increasing T and N category and histologic findings other than adenocarcinoma were significant predictors of decreased OS. Additionally, adjuvant chemoradiotherapy was a significant predictor of improved OS after adjusting for these prognostic factors (hazard ratio for death, 0.3; 95% confidence interval, 0.13-0.69; p = .004).

CONCLUSION:

After adjusting for the stage parameters and histologic findings, our data suggest that adjuvant chemoradiotherapy might improve OS for patients with gallbladder cancer.

PMID:
19297105
DOI:
10.1016/j.ijrobp.2008.10.052
[Indexed for MEDLINE]
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