Richard S Hoehn1, Koffi Wima1, Audrey E Ertel1, Alexandra Meier1, Syed A Ahmad2, Shimul A Shah1, Daniel E Abbott3,4. 1. Cincinnati Research in Outcomes and Safety in Surgery (CROSS), Department of Surgery, University of Cincinnati School of Medicine, Cincinnati, OH, USA. 2. Division of Surgical Oncology, University of Cincinnati School of Medicine, 231 Albert Sabin Way, ML 0558, Cincinnati, OH, 45267-0558, USA. 3. Cincinnati Research in Outcomes and Safety in Surgery (CROSS), Department of Surgery, University of Cincinnati School of Medicine, Cincinnati, OH, USA. abbottdl@ucmail.uc.edu. 4. Division of Surgical Oncology, University of Cincinnati School of Medicine, 231 Albert Sabin Way, ML 0558, Cincinnati, OH, 45267-0558, USA. abbottdl@ucmail.uc.edu.
Abstract
BACKGROUND: The role of adjuvant therapy in patients with resected gallbladder cancer (GBC) is unclear. METHODS: The American College of Surgeons National Cancer Data Base was used to identify patients with resected GBC (pathologic stage 1-3) from 1998 to 2006 (n = 6690). We compared three groups: surgery only (S, 78.6 %), surgery plus adjuvant chemotherapy (AC, 6.2 %), and surgery plus adjuvant chemotherapy and radiation therapy (ACR, 15.1 %). Univariate and Cox regression analyses were used to determine factors influencing overall survival and the use of adjuvant therapy. RESULTS: ACR was associated with improved survival for all patients (HR 0.77, 95 % CI 0.66-0.90), especially node-positive patients (HR 0.64, 95 % CI 0.53-0.78); AC was not associated with changes in survival. Patients were less likely to have their lymph nodes examined if they had any comorbidities, lower income, or were treated at community cancer centers (all p < 0.05). Among patients with unknown lymph node status, those with T2 or T3 disease saw improved survival with ACR (T2: HR 0.79, 95 % CI 0.63-0.99; T3: HR 0.43, 95 % CI 0.30-0.62), while AC did not affect survival. CONCLUSION: ACR is associated with improved survival for patients with node-positive GBC, as well as those with T2 or T3 GBC with unknown lymph node status.
BACKGROUND: The role of adjuvant therapy in patients with resected gallbladder cancer (GBC) is unclear. METHODS: The American College of Surgeons National Cancer Data Base was used to identify patients with resected GBC (pathologic stage 1-3) from 1998 to 2006 (n = 6690). We compared three groups: surgery only (S, 78.6 %), surgery plus adjuvant chemotherapy (AC, 6.2 %), and surgery plus adjuvant chemotherapy and radiation therapy (ACR, 15.1 %). Univariate and Cox regression analyses were used to determine factors influencing overall survival and the use of adjuvant therapy. RESULTS:ACR was associated with improved survival for all patients (HR 0.77, 95 % CI 0.66-0.90), especially node-positive patients (HR 0.64, 95 % CI 0.53-0.78); AC was not associated with changes in survival. Patients were less likely to have their lymph nodes examined if they had any comorbidities, lower income, or were treated at community cancer centers (all p < 0.05). Among patients with unknown lymph node status, those with T2 or T3 disease saw improved survival with ACR (T2: HR 0.79, 95 % CI 0.63-0.99; T3: HR 0.43, 95 % CI 0.30-0.62), while AC did not affect survival. CONCLUSION:ACR is associated with improved survival for patients with node-positive GBC, as well as those with T2 or T3 GBC with unknown lymph node status.
Entities:
Keywords:
Adjuvant therapy; Chemotherapy; Gallbladder cancer; Radiation; Surgery
Authors: Samuel J Wang; Andrew Lemieux; Jayashree Kalpathy-Cramer; Celine B Ord; Gary V Walker; C David Fuller; Jong-Sung Kim; Charles R Thomas Journal: J Clin Oncol Date: 2011-11-07 Impact factor: 44.544
Authors: Bettina Müller; José A Sola; Marcela Carcamo; Ana M Ciudad; Cristian Trujillo; Berta Cerda Journal: Indian J Cancer Date: 2013 Jul-Sep Impact factor: 1.224
Authors: Yuhree Kim; Neda Amini; Ana Wilson; Georgios A Margonis; Cecilia G Ethun; George Poultsides; Thuy Tran; Kamran Idrees; Chelsea A Isom; Ryan C Fields; Bradley Krasnick; Sharon M Weber; Ahmed Salem; Robert C G Martin; Charles Scoggins; Perry Shen; Harveshp D Mogal; Carl Schmidt; Eliza Beal; Ioannis Hatzaras; Rivfka Shenoy; Kenneth Cardona; Shishir K Maithel; Timothy M Pawlik Journal: Ann Surg Oncol Date: 2016-05-11 Impact factor: 5.344
Authors: Omid Salehi; Eduardo A Vega; Sebastian Mellado; Michael J Core; Mu Li; Olga Kozyreva; Onur C Kutlu; Richard Freeman; Claudius Conrad Journal: J Gastrointest Surg Date: 2022-04-08 Impact factor: 3.267
Authors: Edward Christopher Dee; Morgan E Freret; Nora Horick; Ann C Raldow; Lipika Goyal; Andrew X Zhu; Aparna R Parikh; David P Ryan; Jeffrey W Clark; Jill N Allen; Cristina R Ferrone; Carlos Fernandez-Del Castillo; Kenneth K Tanabe; Lorraine C Drapek; Theodore S Hong; Motaz Qadan; Jennifer Y Wo Journal: Ann Surg Oncol Date: 2020-08-01 Impact factor: 5.344