Adjuvant Therapy for Gallbladder Carcinoma: The Mayo Clinic Experience

Journal Article · Tue Sep 01 04:00:00 EDT 2009 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2008.10.052· OSTI ID:21282006

Gold, Douglas G ^[1]; Haddock, Michael G ^[1]; Gunderson, Leonard L ^[2]; Quevedo, Fernando ^[3]; Donohue, John H ^[4]; Bhatia, Sumita ^[1]; Nagorney, David M ^[4]

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1. Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States)
2. Department of Radiation Oncology, Mayo Clinic, Scottsdale, Arizona (United States)
3. Division of Medical Oncology, Mayo Clinic, Rochester, Minnesota (United States)
4. Division of Gastroenterologic and General Surgery, Mayo Clinic, Rochester, Minnesota (United States)

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.

• OSTI ID: 21282006
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 1 Vol. 75; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BILIARY TRACT
CARCINOMAS
CHEMOTHERAPY
COMBINED THERAPY
DEATH
HAZARDS
MULTIVARIATE ANALYSIS
PATIENTS
RADIOTHERAPY
SURGERY
URACILS