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Adjuvant chemoradiotherapy in resected gallbladder cancer: A SEER-based study
Yong Jiang1, Liyong Jiang1, Hongxin Li1
1Department of Liver Transplantation and Hepatobiliary Surgery, Shandong Provincial Hospital, Shandong University, Jinan, China.
Heliyon
|March 23, 2023
Summary
Adjuvant chemoradiotherapy (ACR) combined with surgery significantly improves survival for gallbladder cancer (GBC) patients, especially those with advanced stages. Surgery alone or with chemotherapy showed similar outcomes.
Area of Science:
- Oncology
- Surgical Oncology
- Radiotherapy
Background:
- Gallbladder cancer (GBC) presents a poor prognosis.
- Treatment options include surgery alone (S), adjuvant chemotherapy (AC), and adjuvant chemoradiotherapy (ACR).
Purpose of the Study:
- To compare the survival outcomes of adjuvant chemoradiotherapy (ACR) versus surgery alone (S) and adjuvant chemotherapy (AC) in gallbladder cancer patients.
- To evaluate the efficacy of different treatment modalities for GBC.
Main Methods:
- Utilized the Surveillance, Epidemiology, and End Results (SEER) database (2004-2015).
- Included patients diagnosed with GBC who underwent surgery.
- Employed propensity score matching (PSM) for 1:1:1 group allocation (S, AC, ACR).
- Assessed overall survival using Kaplan-Meier curves and log-rank tests, with subgroup analyses.
Main Results:
- ACR demonstrated improved two-year survival (45%) compared to AC (39%) and S (36%).
- AC and S groups showed similar survival rates (p=0.127).
- ACR significantly improved survival over AC (p=0.012).
- ACR showed significant survival benefits in advanced stages (IIIa, IIIb, IVb), but not in stage II.
Conclusions:
- Combining surgery with adjuvant chemoradiotherapy (ACR) offers superior survival benefits for gallbladder cancer patients.
- ACR is particularly effective for patients with advanced tumor staging.
