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Adjuvant Radiation Therapy Improves Gallbladder Cancer Survival: Presented at SSO

By Crystal Phend

SAN DIEGO, C.A. -- March 28, 2006 -- Although optimal management of gallbladder cancer is still under debate, adjuvant radiation therapy appears to give a survival advantage, according to research presented here at the annual meeting of the Society of Surgical Oncology (SSO).

Gallbladder cancer is relatively rare, but its prognosis is poor with a 5-year survival rate of about 10%.

Researchers led by Pablo Mojica, MD, surgical oncology fellow, City of Hope National Medical Center, Duarte, California, United States, analyzed the Surveillance, Epidemiological, and End Results (SEER) database for survival in individuals with gallbladder adenocarcinoma.

Of 3187 patients with the cancer, 2325 underwent surgical resection; 77% had a simple cholecystectomy, 10% radical surgery and 13% had other surgery. Adjuvant radiation therapy was administered to 17% of patients.

Median survival overall was 10 months, Dr. Mojica said during his presentation on March 25^th.

Survival after radiation therapy was statistically superior until about 3.5 years after treatment and then was similar to survival rates for patients not treated with radiation therapy out to 5 years of follow up.

Multivariate analysis showed that adjuvant radiation was associated with significantly better survival rates, as were older age at diagnosis, positive lymph nodes, male gender, and lower stage.

Stage I and II cancers were much more likely to be treated with surgery alone (49% and 43%, respectively) compared to stage III disease (7%). Surgery and radiation therapy was a more common strategy for stage II cancers (60%) compared to stage I or III (31% and 8% respectively).

In patients treated with radiation therapy, T1, T2 and N0 cancers did not show any difference in survival.

Node positive cancers were 'modestly' more responsive to radiation therapy, with a 5-year survival rate of 11% with radiation therapy compared to 4% without it, Dr. Mojica said.

There was a significant improvement in overall survival for patients who received radiation therapy. Even when looking at only those patients who were alive 3 months after surgery and therefore able to receive adjuvant radiation therapy, there was a significant difference in 5-year survival in favor of radiation therapy (14% vs. 7%).

"Prospective evaluation of adjuvant radiation therapy in gallbladder cancer patients…is warranted," Dr. Mojica said.


[Presentation title: Adjuvant Radiation Therapy Improves Survival for Gallbladder Carcinoma. Session 73]

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