Role of Adjuvant Treatment in High-risk Patients Following Resection for Gallbladder Cancer

Abstract

Aim: To identify prognostic factors for surgically resected gallbladder cancer (GBC).

Patients and methods: Medical records of 66 patients with GBC undergoing potentially curative resection between 2001 and 2017 were retrospectively reviewed.

Results: After a median follow-up of 39.9 months (range=0.5-216.4 months), 22 locoregional recurrences and 25 distant metastases occurred. Adjuvant radiotherapy and adjuvant chemotherapy failed to prove efficacy in all patient groups. In patients with stage III-IV GBC, adjuvant chemotherapy showed a marginally positive effect on locoregional control (p=0.064), and was significantly beneficial for overall survival (p=0.040), and adjuvant treatment improved both locoregional control and overall survival (p=0.029 and p=0.005, respectively). On multivariate analysis, a negative resection margin was a significant prognostic factor for superior local control, and disease-free and overall survival (p=0.003, p=0.010 and p=0.005, respectively) and adjuvant treatment was associated with improved overall survival (p=0.018).

Conclusion: Adjuvant treatment is recommended for patients with stage III-IV GBC following curative surgical resection.

Keywords: Gallbladder cancer; adjuvant chemotherapy; adjuvant radiotherapy; adjuvant treatment; prognostic factor.