Cancer Res Treat.  2016 Oct;48(4):1274-1285. 10.4143/crt.2015.502.

Is There a Role for Adjuvant Therapy in R0 Resected Gallbladder Cancer?: A Propensity Score-Matched Analysis

• Go SI
• Kim YS
• Hwang IG
• Kim EY
• Oh SY
• Ji JH
• Song HN
• Park SH
• Park JO
• Kang JH

• KMID: 2356229
• DOI: http://doi.org/10.4143/crt.2015.502

Abstract

PURPOSE
The purpose of this study is to assess the role of adjuvant therapy in stage I-III gallbladder cancer (GBC) patients who have undergone R0 resection.
MATERIALS AND METHODS
Clinical data were collected on 441 consecutive patients who underwent R0 resection for stage I-III GBC. Eligible patients were classified into adjuvant therapy and surveillance only groups. Propensity score matching (PSM) between the two groups was performed, adjusting clinical factors.
RESULTS
In total, 84 and 279 patients treated with adjuvant therapy and followed up with surveillance only, respectively, were included in the analysis. Before PSM, the 5-year relapse-free survival (RFS) rate was lower in the adjuvant therapy group than in the surveillance only group (50.8% vs. 74.8%, p < 0.001), although there was no statistically significant difference in the 5-year overall survival (OS) rate (66.2% vs. 79.5%, p=0.089). After the PSM, baseline characteristics became comparable and there were no differences in the 5-year RFS (50.8% vs. 64.8%, p=0.319) and OS (66.2% vs. 70.4%, p=0.703) rates between the two groups.
CONCLUSION
The results suggest that fluoropyrimidine-based adjuvant therapy is not indicated in stage I-III GBC patients who have undergone R0 resection.

Keyword

Gallbladder neoplasms; Adjuvant chemotherapy; Adjuvant chemoradiotherapy; Survival; Propensity score

MeSH Terms

Chemoradiotherapy, Adjuvant
Chemotherapy, Adjuvant
Gallbladder Neoplasms*
Gallbladder*
Humans
Propensity Score

Figure

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  Fig. 1. Study schema. GBC, gallbladder cancer; AJCC, American Joint Committee on Cancer; CA 19-9, carbohydrate antigen 19-9.

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  Fig. 2. Kaplan-Meier survival curves according to the type of postoperative treatment. (A) Relapse-free survival before propensity score matching (PSM). (B) Overall survival before PSM. (C) Relapse-free survival after PSM. (D) Overall survival after PSM.

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  Fig. 3. Forest plot of subgroup analysis of overall survival. HR, hazard ratio; CI, confidence interval; W/D, well-differentiated; M/D, moderately differentiated; P/D, poorly differentiated; U/D, undifferentiated; CA 19-9, carbohydrate antigen 19-9.

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  Fig. 4. Kaplan-Meier survival curves according to the type of postoperative treatment (adjuvant therapy group only). (A) Relapse-free survival. (B) Overall survival. CCRT, concurrent chemoradiotherapy.

Reference

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