ADJUVANT TREATMENT FOR ADVANCED GALLBLADDER CANCER; DOES EXTERNAL BEAM RADIATION THERAPY PLAY A ROLE?
Eliahu Y. Bekhor*1,2, Nathan M. Bolton1, Brianne Sullivan1, Daniel Solomon1,2, Natasha DeNicola1, Margaret Hofstedt1, Jacquelyn Carr1, Benjamin Golas1, Deepa Magge1, Umut Sarpel1, Daniel Labow1
1Division of Surgical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY; 2Department of surgery, Rabin medical center, Petach Tikva, Israel
Introduction: Gallbladder cancer (GBC) is rare malignancy that often carries a poor prognosis. To date, resection is the only curative treatment. The role of external beam radiation therapy (EBRT) in addition to adjuvant chemotherapy has not been well-established.
Methods: We retrospectively analyzed all patients with advanced gallbladder malignancy that underwent surgical removal of the gallbladder in our health system from 2007 to 2017. Overall, 40 patients with advanced (TNM stage III/IV) GBC underwent resection for curative purposes. We compared clinical and oncological outcomes for two groups of patients: a group of 19 patients who received adjuvant chemotherapy alone (ACT) and a group of 21 patients who received adjuvant chemo-radiation treatment (ACR).
Results: The two groups were comparable (p=NS) in terms of mean age (ACT 65 vs ACR 62), gender (female, %, 68 vs 52), mean ASA score (2.3 vs 2.0), TNM stage III (%, 90 vs 91), neoadjuvant chemotherapy administration (%, 16 vs 9), and radical cholecystectomy (%, 95 vs 100).
At a mean follow-up of more than 25 months, 27 patients recurred (%, 73 vs 62, p=0.51). The two groups had identical progression free survival (mean months, 18 vs 18, p=0.41), and similar overall survival (mean months, 26 vs 25, p=0.62).
Conclusions: From our small cohort in our single institution, we were not able to show any additional benefit in exposing patients to EBRT in addition to chemotherapy as adjuvant treatment for GBC. Prospective, randomized trials would be needed to further evaluate the role of EBRT in this population.
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