Adjuvant Therapy in Patients with Gallbladder Carcinoma

Abstract

AIM: This study aimed to investigate the effects of adjuvant therapy and chemotherapeutic agents on survival of patients with gallbladder carcinoma. Factors that may affect survival were examined. Method: The files of 74 patients who had been followed between 2004 and 2013 were retrospectively reviewed. Only stage I-III gallbladder carcinoma patients were included in the study. Results: The median age was 65 (36-82) years and 55 (74.4%) of the patients were female. Stage I was determined in 12 (16.2%) patients, whereas Stage II and III were determined in 62 (83.8%) patients. All of the patients had undergone surgical intervention. Positive surgical margin was present in 21 (28.4%) patients and 14 (58.4%) of these patients were re-operated. Thirty-nine (52.7%) patients received chemotherapy. The combination of cisplatin-fluorouracil was the most commonly used chemotherapy regimen, received by 15 (38.5%) patients. Radiotherapy alone was performed in none of the patients, while 8 (10.8%) patients received chemoradiotherapy. Whereas DFS was 21±1.7 (17.2-24.9 95% CI) in the adjuvant therapy arm, OS was found to be 24±2.05 (19.9-28.9 95% CI). DFS was 23±6.7 (9.7-36.3 95% CI) and OS was 28±2.8 (22.5-33.5 95% CI) in the patients that did not receive adjuvant therapy. The differences in both DFS (p=0.246) and OS were not statistically significant (p=0.534). The effectiveness of adjuvant therapy on DFS and OS in the subgroups (surgical margin positivity, stage II patients, older than 65 years old) was statistically significant. Conclusion: There is no standard adjuvant therapy for gallbladder carcinoma. The present study demonstrated the favorable effect of adjuvant therapy, particularly for selected patients. Prospective studies in large patient groups are needed to clarify the benefits of adjuvant therapy.