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

Cancer Res Treat. 2016 Oct;48(4):1274-1285. doi: 10.4143/crt.2015.502. Epub 2016 Feb 12.

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.

Keywords: Adjuvant chemoradiotherapy; Adjuvant chemotherapy; Gallbladder neoplasms; Propensity score; Survival.

MeSH terms

  • Aged
  • Chemoradiotherapy, Adjuvant / adverse effects
  • Chemotherapy, Adjuvant / adverse effects
  • Combined Modality Therapy
  • Disease-Free Survival
  • Female
  • Fluorouracil / administration & dosage*
  • Fluorouracil / adverse effects
  • Gallbladder Neoplasms / drug therapy*
  • Gallbladder Neoplasms / epidemiology
  • Gallbladder Neoplasms / pathology
  • Gallbladder Neoplasms / radiotherapy
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / drug therapy*
  • Neoplasm Recurrence, Local / epidemiology
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / radiotherapy
  • Neoplasm Staging
  • Propensity Score
  • Treatment Outcome

Substances

  • Fluorouracil