Related Experiment Video
Updated: Jun 8, 2025
Complete Laparoscopic Radical Resection of Perihilar Cholangiocarcinoma Type IIIb
Published on: January 17, 2025
Individualizing care for patients with gallbladder cancer
Laura M Nicolais1, Timothy L Fitzgerald2
1Division of Surgical Oncology, Tufts University School of Medicine-Maine Medical Center, 22 Bramhall St., Portland, ME, 04102, USA; Tufts University Clinical and Translational Science Graduate Program, Graduate School of Biomedical Sciences, 35 Kneeland St., Boston, MA, 02111, USA.
Abstract:
The rarity and lack of Level I Evidence compromise our ability to care for patients with gallbladder cancer.
Methods:
NCDB cohort study of with resected Stage Groups IB-IVA gallbladder adenocarcinoma between 2004 and 2018. Patients were included.
Results:
8484 patients were included, median survival was 29.8 (CI 28.6-31.2); Stage IB: 67.0, Stage II: 36.6, and Stage III/IVA 18.4 months. A survival benefit was noted for surgery beyond cholecystectomy (Stage IB 105 vs. 36 months, HR 0.56, p < 0.001; Stage II 56 vs. 20 months, HR 0.72, p < 0.001; and Stage III/IVA 23.8 vs. 9.9 months, HR 0.67, p < 0.001) and chemoradiotherapy (Stage IB 102 vs. 64.8, HR 0.87, CI 0.62-1.23, p = 0.4; ' Stage II 49 vs. 33.5 months, HR 0.78, CI 0.68-0.91, p = 0.002; and Stage III/IVA 31 vs. 12.2 HR 0.60, CI 0.52-0.70, p < 0.001). Adjuvant chemotherapy improved survival in Stage III/IVA (20 vs. 12.2 months, HR 0.74, p < 0.001) but not Stage II and trend toward harm in Stage IB. A nomogram with created with these data.
Conclusion:
Surgery beyond cholecystectomy provides a benefit to all. Adjuvant chemotherapy (Stage III and IVA) benefits and chemoradiotherapy (II, III, and IVA) only patients with higher stage disease.
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