Influence of adjuvant therapy on pattern of failure and survival in curatively resected gallbladder carcinoma
Sunil Choudhary1, Neha Gupta2, Chandra Prakash Verma2, Avipsa Das3, Lalit Mohan Aggarwal1, Mallika Tewari4, Abhijit Mandal1, Anupam Kumar Asthana1
1 Department of Radiotherapy and Radiation Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
2 Department of Radiotherapy, Apex Cancer Institute, Apex Hospital, Varanasi, Uttar Pradesh, India
3 Department of Radiation Oncology, Tata Memorial Centre, Kolkata, West Bengal, India
4 Department of Surgical Oncology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
Apex Cancer Institute, Apex Hospital, Varanasi, Uttar Pradesh
Source of Support: None, Conflict of Interest: None
Purpose: The study was done to evaluate the role of adjuvant therapy in curatively resected Stage II and III gallbladder carcinoma (GBC).
Materials and Methods: This was a retrospective analysis of patients of GBC registered between 2008 and 2017 in outpatient department of a tertiary cancer hospital in India. Patients who had any of the following adjuvant treatment after radical surgery: (a) external beam radiotherapy (RT) alone, (b) chemotherapy (CT) alone, and (c) RT with CT (CRT) were considered for the study.
Results: A total of fifty patients could meet the selection criteria. It was seen that seven patients were treated with RT, 20 with CT, and 23 with CRT. Median follow-up for patients who were alive was 26.7 months. Nineteen patients had locoregional failure while eight had distant failure. Patients treated with CRT had a significantly better mean overall survival compared to those treated with RT or CT (44.0 months, 12.5 months, and 15.1 months, respectively; P = 0.003). Similarly, mean disease-free survival was superior in CRT arm compared to RT and CT arms (43.6 months, 9.6 months, and 12.4 months, respectively; P = 0.002).
Conclusions: Adjuvant CRT had better survival outcome compared to patients treated with either RT or CT with Stage II and III disease after curative cholecystectomy.