Ann Hepatobiliary Pancreat Surg.  2025 Feb;29(1):38-47. 10.14701/ahbps.24-169.

Propensity score analysis of adjuvant therapy in radically resected gallbladder cancers: A real world experience from a regional cancer center

• Agrawal S
• R
• Alam MN
• Rastogi N
• Singh A
• Singh RK
• Behari A
• Mishra P

• KMID: 2565405
• DOI: http://doi.org/10.14701/ahbps.24-169

Abstract

Backgrounds/Aims
Given the high mortality associated with gallbladder cancer (GBC), the efficacy of adjuvant therapy (AT) remains controversial. We audited our data over an 11-year period to assess the impact of AT.
Methods
This study included all patients who underwent curative resection for GBC from 2007 to 2017. Analyses were conducted of clinicopathological characteristics, surgical details, and postoperative therapeutic records. The benefits of adjuvant chemotherapy (CT) or chemoradiotherapy (CTRT) were evaluated against surgery alone using SPSS version 20 for statistical analysis.
Results
The median age of patients (n = 142) was 50 years. The median overall survival (OS) was 93, 34, and 30 months with CT, CTRT, and surgery alone respectively (p = 0.612). Multivariate analysis indicated that only disease stage and microscopically involved margins significantly impacted OS and disease-free survival (DFS). CT showed increased effectiveness across all prognostic subsets, except for stage 4 and margin-positive resections. Following propensity score matching, median DFS and OS were higher in the CT group than in the CTRT group, although the differences were not statistically significant (p > 0.05).
Conclusions
Radically resected GBC patients appear to benefit more from adjuvant CT, while CTRT should be reserved for cases with high-risk features.

Keyword

Gallbladder neoplasm; Propensity score; Chemotherapy adjuvant; Radiotherapy

Figure

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  Fig. 1 Overall survival (OS) according to type of treatment (A), overall stage (B). Stagewise overall survival following chemoradiotherapy (CTRT) (C), following chemotherapy (CT) (D).

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  Fig. 2 Overall survival according to sex (A) and resection status (B).

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  Fig. 3 (A) Overall survival after propensity score matching, (B) Disease-free survival after propensity score matching. CTRT, chemoradiotherapy; CT, chemotherapy.

Reference

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