Potential for adjuvant treatment after radical resection in carcinoma gallbladder: A tertiary care experience from India

Context: Gallbladder cancer represents the most common among the biliary tree cancers. Complete surgical resection offers the best chance for cure. Adjuvant chemotherapy and radiotherapy have increasing role in adjuvant management of carcinoma gall bladder, particularly in subgroup patients with high risk features. Aims: To analyze and identify the risk factors for role of adjuvant chemoradiotherapy in resectable patients of carcinoma gallbladder. Materials and Methods: The study designed as retrospective analysis of 40 postoperative patients of carcinoma gallbladder treated in our institute from 2008 to 2011. Patients treated with curative intent were included in this analysis. Clinical characteristic and treatment in form of surgery, radiotherapy, and chemotherapy were evaluated. For statistical analysis, data was arranged using SPSS 19 version. Descriptive studies were done for all parameters and Kaplan-Meier analysis used for survival analysis. P < 0.05 is considered as statically significant. Results: Forty patients were available for final analysis. Median age of patients was 51 years there were 10 male and 30 female patients. Eleven patients received only adjuvant radiotherapy, 16 patients received adjuvant chemotherapy, and 13 patients received both chemotherapy and radiotherapy. At end of treatment, 85% patients had no evidence of disease and 15% had recurrence. Patients on combined chemotherapy and radiotherapy had better 2-year disease free survival (DFS). Liver infiltration by tumor was found to be a bad prognostic factor with DFS at 1-year of 0.8 vs. 0.5 patients with no liver infiltration (P = 0.06). Conclusion: The present analysis reveals better overall survival in patients who received chemotherapy and radiation rather than single modality treatment. Liver infiltration and adequate lymph node dissection have been found to be two important prognostic factors for considering this subgroup of patients for adjuvant chemotherapy as well as radiotherapy.