Adjuvant Therapy for Gallbladder Carcinoma: The Mayo Clinic Experience

Douglas G. Gold, Robert C. Miller, Michael G. Haddock, Leonard L. Gunderson, Fernando Quevedo, John H. Donohue, Sumita Bhatia, David M. Nagorney

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84 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)150-155
Number of pages6
JournalInternational Journal of Radiation Oncology Biology Physics
Volume75
Issue number1
DOIs
StatePublished - Sep 1 2009

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Keywords

  • Adjuvant therapy
  • Chemotherapy
  • Gallbladder carcinoma
  • Radiotherapy

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

Gold, D. G., Miller, R. C., Haddock, M. G., Gunderson, L. L., Quevedo, F., Donohue, J. H., Bhatia, S., & Nagorney, D. M. (2009). Adjuvant Therapy for Gallbladder Carcinoma: The Mayo Clinic Experience. International Journal of Radiation Oncology Biology Physics, 75(1), 150-155. https://doi.org/10.1016/j.ijrobp.2008.10.052