Individualizing care for patients with gallbladder cancer
Document Type
Article
Publication Date
11-2024
Institution/Department
Oncology; Surgery
Journal Title
Surgical oncology
Abstract
UNLABELLED: The rarity and lack of Level I Evidence compromise our ability to care for patients with gallbladder cancer. METHODS: NCDB cohort study of with resected Stage Groups IB-IVA gallbladder adenocarcinoma between 2004 and 2018. Patients were included. RESULTS: 8484 patients were included, median survival was 29.8 (CI 28.6-31.2); Stage IB: 67.0, Stage II: 36.6, and Stage III/IVA 18.4 months. A survival benefit was noted for surgery beyond cholecystectomy (Stage IB 105 vs. 36 months, HR 0.56, p < 0.001; Stage II 56 vs. 20 months, HR 0.72, p < 0.001; and Stage III/IVA 23.8 vs. 9.9 months, HR 0.67, p < 0.001) and chemoradiotherapy (Stage IB 102 vs. 64.8, HR 0.87, CI 0.62-1.23, p = 0.4; ' Stage II 49 vs. 33.5 months, HR 0.78, CI 0.68-0.91, p = 0.002; and Stage III/IVA 31 vs. 12.2 HR 0.60, CI 0.52-0.70, p < 0.001). Adjuvant chemotherapy improved survival in Stage III/IVA (20 vs. 12.2 months, HR 0.74, p < 0.001) but not Stage II and trend toward harm in Stage IB. A nomogram with created with these data. CONCLUSION: Surgery beyond cholecystectomy provides a benefit to all. Adjuvant chemotherapy (Stage III and IVA) benefits and chemoradiotherapy (II, III, and IVA) only patients with higher stage disease.
First Page
102163
Recommended Citation
Nicolais, Laura M. and Fitzgerald, Timothy, "Individualizing care for patients with gallbladder cancer" (2024). MaineHealth Maine Medical Center. 3843.
https://knowledgeconnection.mainehealth.org/mmc/3843