David H. Ilson, MD, PhD reviewing Mantripragada KC et al. J Natl Cancer Inst 2017 Feb

No clear survival benefit was observed with adjuvant chemotherapy or radiation therapy.

The role of adjuvant chemotherapy or radiation therapy for patients with resected gallbladder cancer remains controversial, as mixed conclusions have been drawn from largely uncontrolled, retrospective studies.

Investigators have now used data from the National Cancer Database to study more than 8500 patients (70% female; median age, 72) who underwent curative resection for gallbladder cancer at more than 1500 facilities from 2004 through 2011. Of these patients, 16% had T1 disease, 36% had T2 disease, 21% had T3 disease, and 26% had node-positive disease. Also, 46% of patients underwent laparoscopic surgery, 42% underwent open surgery, and 12% converted from laparoscopic to open surgery.

Adjuvant chemotherapy was given to 29% of patients, of whom 57% received a single agent. Upfront chemoradiotherapy was given to 14% of patients. Of patients receiving upfront chemotherapy alone, 34% received adjuvant radiation therapy down the line.

Overall survival was similar in patients treated with or without adjuvant therapy. In patients receiving upfront chemoradiotherapy, an early potential survival benefit was lost at 5 years.

CITATION(S):

Mantripragada KC et al. Adjuvant therapy for resected gallbladder cancer: Analysis of the National Cancer Data Base. J Natl Cancer Inst 2017 Feb; 109:djw202.

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