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Role of adjuvant chemoradiotherapy and chemotherapy in patients with resected gallbladder carcinoma: a multi-institutional analysis (KROG 19-04)

 Sung Uk Lee  ;  Jinsil Seong  ;  Tae Hyun Kim  ;  Jung Ho Im  ;  Woo Chul Kim  ;  Kyubo Kim  ;  Hae Jin Park  ;  Tae Gyu Kim  ;  Youngkyong Kim  ;  Bae Kwon Jeong  ;  Jin Hee Kim  ;  Byoung Hyuck Kim  ;  Taek-Keun Nam 
 CANCER BIOLOGY & MEDICINE, Vol.19(6) : 931-944, 2022-06 
Journal Title
Issue Date
Chemoradiotherapy, Adjuvant* ; Combined Modality Therapy ; Gallbladder Neoplasms* / pathology ; Gallbladder Neoplasms* / surgery ; Humans ; Neoplasm Staging
Gallbladder cancer ; adjuvant treatment ; chemoradiotherapy ; locoregional recurrence-free survival ; overall survival
Objective: The effectiveness of adjuvant treatments for resected gallbladder carcinoma (GBC) has remained unclear due to lack of randomized controlled trials; thus, the aim of present study was to evaluate the role of adjuvant treatments, including chemoradiotherapy (CRT) and/or chemotherapy (CTx), in patients with resected GBC.

Methods: A total of 733 GBC patients who received curative-intent surgical resection were identified in a multi-institutional database. Of 733 patients, 372 (50.8%) did not receive adjuvant treatment, whereas 215 (29.3%) and 146 (19.9%) received adjuvant CTx and CRT, respectively. The locoregional recurrence-free survival (LRFS), recurrence-free survival (RFS), and overall survival (OS) of the adjuvant treatment groups were compared according to tumor stage (stage II vs. stage III-IV).

Results: In stage II disease (n = 381), the 5-year LRFS, RFS, and OS were not significantly different among the no-adjuvant therapy, CTx, and CRT groups, and positive resection margin, presence of perineural invasion, and Nx classification were consistently associated with worse LRFS, RFS, and OS in the multivariate analysis (P < 0.05). For stage III-IV (n = 352), the CRT group had significantly higher 5-year LRFS, RFS, and OS than the no-adjuvant therapy and CTx groups (67.8%, 45.2%, and 56.9%; 37.9%, 28.8%, and 35.4%; and 45.0%, 30.0%, and 45.7%, respectively) (P < 0.05).

Conclusions: CRT has value as adjuvant treatment for resected GBC with stage III-IV disease. Further study is needed for stage II disease with high-risk features.
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1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Seong, Jin Sil(성진실) ORCID logo https://orcid.org/0000-0003-1794-5951
Im, Jung Ho(임정호)
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