Adjuvant chemoradiotherapy for gallbladder carcinoma after RO resection / 中华普通外科杂志

ABSTRACT

Objective To evaluate adjuvant chemoradiotherapy on gallbladder carcinoma after RO resection.Methods A total of 54 patients undergoing curative resection (R0) for gallbladder carcinoma between January 1991 and December 2006 were recruited for evaluation on the effect of postoperative adjuvant chemoradiotherapy,with the exception of 5 TINOM0 patients.Among the remaining 49 patients,11 patients received radiotherapy,and 21 cases had undergone adjuvant chemotherapy.Results The overall 1,3 and 5-year survival rates of these 54 patients were 81.1％,54.4％ and 48.4％,respectively.The overall 5-year survival rates of T1,T2,T3 and T4 were 100％,92.3％,27.8％ and 12.5％ ( x2 =25.307,P ＜0.001 ),respectively.The median survival for those patients receiving adjuvant radiotherapy was 12.8 months compared to 28 months of median survival for those treated without adjuvant radiation therapy (x2 =3.942,P =0.047 ).Adjuvant radiotherapy significantly prolonged overall median survival from 16 months to 95 months ( x2 =5.387,P =0.02 ) in the subgroup of patients with T3/T4 stage.Adjuvant radiotherapy for patients with positive lymph nodes improved overall median survival from 12 to 19 months (x2 =3.959,P =0.047 ).In addition,radiotherapy prolonged overall median survival from 12 moths to 128 months in patients with G3/G4 disease ( x2 =7.401,P =0.007).The median survival was not significantly different among patients with or without adjuvant chemotherapy (x2=0.086,P=0.770 ).Conclusions Adjuvant radiotherapy is recommended for lymph node positive,T3/T4,or G3/G4 gallbladder carcinoma patients following R0 resection.