Radiat Oncol J.  2017 Dec;35(4):359-367. 10.3857/roj.2017.00388.

Patterns of initial failure after resection for gallbladder cancer: implications for adjuvant radiotherapy

• Kim TG

• KMID: 2401790
• DOI: http://doi.org/10.3857/roj.2017.00388

Abstract

PURPOSE
This study sought to identify potential candidates for adjuvant radiotherapy and patterns of regional failure in patients who underwent curative-intent surgery for gallbladder cancer.
MATERIALS AND METHODS
Records for 70 patients with gallbladder cancer who underwent curative resection at a single institution between 2000 and 2016 were analysed retrospectively. No patients received adjuvant radiotherapy. Initial patterns of failure were evaluated. Regional recurrence was categorized according to the definitions of lymph node stations suggested by the Japanese Society of Hepato-Biliary-Pancreatic Surgery.
RESULTS
Median follow-up was 23 months. Locoregional recurrence as any component of first failure occurred in 29 patients (41.4%), with isolated locoregional recurrence in 13 (18.6%). Regional recurrence occurred in 23 patients, and 77 regional recurrences were identified. Commonly involved regional stations were #13, #12a2, #12p2, #12b2, #16a2, #16b1, #9, and #8. Independent prognostic factors for locoregional recurrence were ≥pT2 disease (hazard ratio [HR], 5.510; 95% confidence interval [CI], 1.260-24.094; p = 0.023) and R1 resection (HR, 6.981; 95% CI, 2.378-20.491; p < 0.001).
CONCLUSION
Patients with pT2 disease or R1 resection after curative surgery for gallbladder cancer may benefit from adjuvant radiotherapy. Our findings on regional recurrence may help physicians construct a target volume for adjuvant radiotherapy.

Keyword

Gallbladder cancer; Adjuvant radiotherapy; Locoregional neoplasm recurrences; Lymph node; Lymphatic irradiation

MeSH Terms

Asian Continental Ancestry Group
Follow-Up Studies
Gallbladder Neoplasms*
Gallbladder*
Humans
Lymph Nodes
Lymphatic Irradiation
Neoplasm Recurrence, Local
Radiotherapy, Adjuvant*
Recurrence
Retrospective Studies