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Journal of Radiation Oncology

, Volume 8, Issue 2, pp 157–162 | Cite as

Adjuvant chemoradiation in resected gallbladder cancer: a prognostic index model for predicting overall survival

  • Claudio V. SoleEmail author
  • Lorena Vargas
  • Vicente J. Sole
  • Francisco Larsen
  • Sebastian Sole
Original Research

Abstract

Purpose

Patients with gallbladder cancer (GBC) have a dismal prognosis. We investigated outcomes and risk factors for overall survival (OS) in patients treated with radical surgery and adjuvant chemoradiotherapy (CRT).

Materials/methods

A total of 212 patients with LAGC (⩾pT3 59% and/or pN+ 52%) were studied. The primary endpoint of the analysis was OS. We constructed a risk scoring system in which points were assigned to each risk factor by dividing each β coefficient in the final model by the lowest β coefficient and rounding to the nearest integer. A risk score was assigned to each subject by adding up the points for each risk factor present. Subjects were then divided into three risk groups based on their risk scores (0 points = low risk, 1–2 points = intermediate risk, 3–6 points = high risk).

Results

Median follow-up was 46.2 months (2–235). Five-year OS for the entire cohort was 53%. In multivariate analysis, higher pT stage [HR, 2.43 (1.29–3.68); p = 0.01], R1 resection [HR, 5.06 (3.12–8.19); p < 0.001], and number of surgical procedures [HR, 1.41 (1.01–2.16); p = 0.05] were associated with an increased risk of death. Five-year OS for patients with low (n = 63), intermediate (n = 94), and high (n = 55) risk was 79.1%, 51.2%, and 9.5%, respectively.

Conclusion

Overall results after multimodality treatment of GBC are promising. A risk model was generated to determine a prognostic index for individual patients with GBC. Classification of risk factors for death has contributed to propose a prognostic index that could allow us to guide risk-adapted tailored treatment.

Keywords

Gallbladder cancer Radiotherapy Overall survival 

Notes

Compliance with ethical standards

Funding

No funding was received for this study.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in the study were in accordance with the ethical standards of the national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Radiation OncologyInstituto de RadiomedicinaSantiagoChile
  2. 2.Radiation Medicine ProgramInstituto de RadiomedicinaSantiagoChile
  3. 3.School of MedicineDiego Portales UniversitySantiagoChile
  4. 4.Instituto de Investigación Sanitaria Gregorio MaranónMadridSpain
  5. 5.School of MedicineSan Sebastian UniversitySantiagoChile

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