Outcome of Adjuvant Therapy for Gallbladder CancerPark H.S.a · Lim J.Y.a · Yoon D.S.b · Park J.S.b · Lee D.K.a · Lee S.J.a · Choi H.J.c · Song S.Y.c · Lee W.J.d · Cho J.Y.a
Departments of aInternal Medicine and bSurgery, Gangnam Severance Hospital, and Departments of cInternal Medicine and dSurgery, Shinchon Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
Do you have an account?
- Rent for 48h to view
- Buy Cloud Access for unlimited viewing via different devices
- Synchronizing in the ReadCube Cloud
- Printing and saving restrictions apply
Rental: USD 8.50
Cloud: USD 20.00
Article / Publication Details
Objectives: The aim of this study was to evaluate the outcome of adjuvant therapy on the overall survival (OS) and disease-free survival (DFS) after curative resection (RO) of patients with TNM stage II gallbladder (GB) cancer. Methods: A total of 160 patients who had received curative resection (RO) between January 2000 and December 2009 were retrospectively reviewed. Among 61 stage II GB cancer patients, 43 received adjuvant therapy, while 18 others received surgery alone. The median follow-up period was 27.3 months (range 2.2–98.9 months). Results: OS was not significantly different among the adjuvant therapies (p = 0.180), but DFS was (p = 0.033). The 3-year OS and DFS from surgery alone, adjuvant chemotherapy, adjuvant radiotherapy, and adjuvant concurrent chemo-radiotherapy were 64, 78, 36 and 36%, and 56, 69, 14 and 47%, respectively. Overall, the chemotherapy group had a better prognosis, although there were no significant differences. Conclusions: The data from this study do not provide evidence that adjuvant therapy is an effective treatment option for curative resected GB cancer. A large randomized controlled study is necessary to confirm the efficacy of adjuvant therapy. Newer adjuvant studies should be focused on gemcitabine-based chemotherapy or chemo-radiotherapy with molecular-based target agents.
© 2010 S. Karger AG, Basel
- Gourgiotis S, Kocher HM, Solaini L, Yarollahi A, Tsiambas E, Salemis NS: Gallbladder cancer. Am J Surg 2008;196:252–264.
- Miller G, Jarnagin WR: Gallbladder carcinoma. Eur J Surg Oncol 2008;34:306–312.
- Bartlett DL: Gallbladder cancer. Semin Surg Oncol 2000;19:145–155.
- Randi G, Franceschi S, La Vecchia C: Gallbladder cancer worldwide: geographical distribution and risk factors. Int J Cancer 2006;118:1591–1602.
- Jemal A, Siegel R, Ward E, Hao Y, Xu J, Thun MJ: Cancer statistics, 2009. CA Cancer J Clin 2009;59:225–249.
- Czito BG, Hurwitz HI, Clough RW, Tyler DS, Morse MA, Clary BM, Pappas TN, Fernando NH, Willett CG: Adjuvant external-beam radiotherapy with concurrent chemotherapy after resection of primary gallbladder carcinoma: a 23-year experience. Int J Radiat Oncol Biol Phys 2005;62:1030–1034.
- Mahe M, Stampfli C, Romestaing P, Salerno N, Gerard JP: Primary carcinoma of the gall-bladder: potential for external radiation therapy. Radiother Oncol 1994;33:204–208.
- Mojica P, Smith D, Ellenhorn J: Adjuvant radiation therapy is associated with improved survival for gallbladder carcinoma with regional metastatic disease. J Surg Oncol 2007;96:8–13.
- Tsukada K, Hatakeyama K, Kurosaki I, Uchida K, Shirai Y, Muto T, Yoshida K: Outcome of radical surgery for carcinoma of the gallbladder according to the TNM stage. Surgery 1996;120:816–821.
- Takada T, Amano H, Yasuda H, Nimura Y, Matsushiro T, Kato H, Nagakawa T, Nakayama T: Is postoperative adjuvant chemotherapy useful for gallbladder carcinoma? A phase III multicenter prospective randomized controlled trial in patients with resected pancreaticobiliary carcinoma. Cancer 2002;95:1685–1695.
- Bartlett DL, Fong Y, Fortner JG, Brennan MF, Blumgart LH: Long-term results after resection for gallbladder cancer: implications for staging and management. Ann Surg 1996;224:639–646.
- Cho SY, Kim SH, Park SJ, Han SS, Kim YK, Lee KW, Lee WJ, Woo SM, Kim TH: Adjuvant chemoradiation therapy in gallbladder cancer. J Surg Oncol 2010;102:87–93.
- Fong Y, Jarnagin W, Blumgart LH: Gallbladder cancer: comparison of patients presenting initially for definitive operation with those presenting after prior noncurative intervention. Ann Surg 2000;232:557–569.
- Endo I, Shimada H, Tanabe M, Fujii Y, Takeda K, Morioka D, Tanaka K, Sekido H, Togo S: Prognostic significance of the number of positive lymph nodes in gallbladder cancer. J Gastrointest Surg 2006;10:999–1007.
- Park JS, Yoon DS, Kim KS, Choi JS, Lee WJ, Chi HS, Kim BR: Actual recurrence patterns and risk factors influencing recurrence after curative resection with stage II gallbladder carcinoma. J Gastrointest Surg 2007;11:631–637.
- Aramaki M, Matsumoto T, Shibata K, Himeno Y, Yada K, Hirano S, Sasaki A, Kawano K, Kitano S: Factors influencing recurrence after surgical treatment for T2 gallbladder carcinoma. Hepatogastroenterology 2004;51:1609–1611.
- Kim WS, Choi DW, You DD, Ho CY, Heo JS, Choi SH: Risk factors influencing recurrence, patterns of recurrence, and the efficacy of adjuvant therapy after radical resection for gallbladder carcinoma. J Gastrointest Surg 2010;14:679–687.
- Itoh H, Nishijima K, Kurosaka Y, Takegawa S, Kiriyama M, Dohba S, Kojima Y, Saitoh Y: Magnitude of combination therapy of radical resection and external beam radiotherapy for patients with carcinomas of the extrahepatic bile duct and gallbladder. Dig Dis Sci 2005;50:2231–2242.
- de Aretxabala X, Roa I, Berrios M, Hepp J, Gallardo J, Cordova A, Roa JC, Leon J, Maluenda F: Chemoradiotherapy in gallbladder cancer. J Surg Oncol 2006;93:699–704.
- Valle J, Wasan H, Palmer DH, Cunningham D, Anthoney A, Maraveyas A, Madhusudan S, Iveson T, Hughes S, Pereira SP, Roughton M, Bridgewater J: Cisplatin plus gemcitabine versus gemcitabine for biliary tract cancer. N Engl J Med 2010;362:1273–1281.
- Lubner SJ, Mahoney MR, Kolesar JL, Loconte NK, Kim GP, Pitot HC, Philip PA, Picus J, Yong WP, Horvath L, Van Hazel G, Erlichman CE, Holen KD: Report of a multicenter phase ii trial testing a combination of biweekly bevacizumab and daily erlotinib in patients with unresectable biliary cancer: a phase II consortium study. J Clin Oncol 2010;28:3491–3497.
- Kresl JJ, Schild SE, Henning GT, Gunderson LL, Donohue J, Pitot H, Haddock MG, Nagorney D: Adjuvant external beam radiation therapy with concurrent chemotherapy in the management of gallbladder carcinoma. Int J Radiat Oncol Biol Phys 2002;52:167–175.
Article / Publication Details
Copyright / Drug Dosage / DisclaimerCopyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.